Individual
DR. JESSIE ELLEN REISIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
65 E 79TH ST, NEW YORK, NY 10075-0216
(212) 772-7668
Mailing address
65 E 79TH ST, NEW YORK, NY 10075-0216
(212) 772-7668
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
060280
NY
Other
Enumeration date
05/24/2016
Last updated
02/21/2020
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