Provider Demographics
NPI:1194781831
Name:REINKING, GREGORY (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:REINKING
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 1:259 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3957
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:347 N KUAKINI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2306
Practice Address - Country:US
Practice Address - Phone:808-522-0190
Practice Address - Fax:808-523-9068
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD113882085R0202X
NY2521492085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI990157698-96701-B011OtherTRICARE
HI9869147OtherHI ELEC
HI0049590403Medicaid
HI00A0227585OtherQUEST HMSA
HI103802483OtherUS MARSHALL SVC-FED DET C
HI108-2145098OtherAETNA
NY05115022Medicaid
HI495904-01OtherST DEPT OF PUB SAFETY
HI990157698OtherAETNA, UHC, CIGNA
HI990157698-96817-E011OtherTRICARE
HI0049590401Medicaid
HI00B0227583OtherQUEST HMSA
HI201243800OtherUS LABOR DEPT
HIB227583OtherHMSA
HIMD11388OtherQUEENS HEALTHCARE
HI495904-03OtherST DEPT OF PUB SAFETY
HI920006125OtherPALMETTO GBA
HIA227585OtherHMSA
HI103802483OtherUS MARSHALL SVC-FED DET C