Individual
CHRISTINA MARIE REISERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
265 BALDWIN PATH, DEER PARK, NY 11729-1417
(516) 859-5930
Mailing address
265 BALDWIN PATH, DEER PARK, NY 11729-1417
(516) 859-5930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
835087
NY
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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