Provider Demographics
NPI:1053926436
Name:REINISCH, DANIEL (LMT, RMBP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:REINISCH
Suffix:
Gender:M
Credentials:LMT, RMBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 W 25TH ST APT 21C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5825
Mailing Address - Country:US
Mailing Address - Phone:212-228-0208
Mailing Address - Fax:
Practice Address - Street 1:365 W 25TH ST APT 21C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5825
Practice Address - Country:US
Practice Address - Phone:212-228-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016049-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist