Individual
DR. ANDREW T REISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, WHITE 1 EMERGENCY ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-4184
(617) 724-0917
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
209107
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140040
—
MA
01
—
209107
TUFTS HEALTH PLAN
MA
01
—
J23528
BCBS MA
MA
Enumeration date
12/06/2005
Last updated
09/08/2014
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