Individual
DR. CHARLES E REISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 RIVER AVE, LAKEWOOD, NJ 08701-5237
(732) 363-1900
Mailing address
1000 HADDONFIELD BERLIN RD, SUITE 210, VOORHEES, NJ 08043-3520
(856) 782-2212
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
25MA05286100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5233101
—
NJ
Enumeration date
08/21/2006
Last updated
07/08/2007
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