Provider Demographics
NPI:1285788513
Name:REISS, ROBERT FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:FRANCIS
Last Name:REISS
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 1:4911 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1007
Mailing Address - Country:US
Mailing Address - Phone:718-446-2739
Mailing Address - Fax:
Practice Address - Street 1:310 E 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6275
Practice Address - Country:US
Practice Address - Phone:212-570-3407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100040207RH0000X, 207ZB0001X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Not Answered207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Not Answered207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology