Provider Demographics
NPI:1831250554
Name:REICHARD, PETER (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:REICHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S. BEDFORD ROAD
Mailing Address - Street 2:CAREMOUNT MEDICAL, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:23 DAVIS AVE
Practice Address - Street 2:CAREMOUNT MEDICAL, PC
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-452-6835
Practice Address - Fax:845-452-0550
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA06544400207L00000X
NY197734207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7918801Medicaid
NY03186481Medicaid
NJ010594CNKMedicare PIN
NYA400163165Medicare PIN
NJ7918801Medicaid