Individual
JOHN MICHAEL REISER
Active
Individual
JOHN MICHAEL REISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
193975
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025112506
UNIVERA
—
01
—
000525977008
BLUE SHIELD OF WESTERN NY
—
05
—
02060997
—
NY
01
—
208616656
FIDELIS
—
01
—
5611064
INDEPENDENT HEALTH
—
01
—
CR1939750B
WORKERS COMPENSATION
NY
01
—
P00259090
RAILROAD MEDICARE
NY
01
—
P00422403
RAILROAD MEDICARE
—
Enumeration date
07/28/2005
Last updated
07/24/2012
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