Provider Demographics
NPI:1417229543
Name:REIS, ELIZABETH (DPT)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:REIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:REIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:119 STANHOPE ST
Mailing Address - Street 2:APT 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-3405
Mailing Address - Country:US
Mailing Address - Phone:513-378-3106
Mailing Address - Fax:
Practice Address - Street 1:171 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2000
Practice Address - Country:US
Practice Address - Phone:212-327-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0339412251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic