Provider Demographics
NPI:1699791665
Name:REISMAN, STEVEN
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:REISMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 86TH ST
Mailing Address - Street 2:NEW YORK CARDIAC DIAGNOSTIC CTR- GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1057
Mailing Address - Country:US
Mailing Address - Phone:212-860-0796
Mailing Address - Fax:212-860-1946
Practice Address - Street 1:115 EAST 86TH STREET
Practice Address - Street 2:NEW YORK CARDIAC DIAGNOSTIC CTR- GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:212-860-0796
Practice Address - Fax:212-860-1946
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1406241174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61112Medicare UPIN