Provider Demographics
NPI:1831253954
Name:REINHARTH, BERNICE MEDNICK (PHD)
Entity type:Individual
Prefix:DR
First Name:BERNICE
Middle Name:MEDNICK
Last Name:REINHARTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SELECT PHYSICIANS PC
Mailing Address - Street 2:410 LAKEVILLE RD.
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11041-0001
Mailing Address - Country:US
Mailing Address - Phone:516-488-9700
Mailing Address - Fax:516-488-8826
Practice Address - Street 1:SELECT PHYSICIANS PC
Practice Address - Street 2:410 LAKEVILLE RD.
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11041-0001
Practice Address - Country:US
Practice Address - Phone:516-488-9700
Practice Address - Fax:516-488-8826
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVM1181Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST