Basic Information
| Provider Information | |||||||||
| NPI: | 1083636393 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REINER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
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| OtherFirstName: | |||||||||
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| OtherCredential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 204 GAINES ST | ||||||||
| Address2: | |||||||||
| City: | PORT TOWNSEND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983686902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603856486 | ||||||||
| FaxNumber: | 3603794996 | ||||||||
| Practice Location | |||||||||
| Address1: | 204 GAINES ST | ||||||||
| Address2: | |||||||||
| City: | PORT TOWNSEND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983686902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603856486 | ||||||||
| FaxNumber: | 3603794996 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 01/14/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 25MD00183200 | NJ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | F11578 | 01 | NJ | HEALTH NET | OTHER | 098994900 | 01 | NJ | INDEPENDENCE BC | OTHER | 1006148 | 01 | NJ | HORIZON NJ HEALTH | OTHER | J40585 | 01 | NJ | AMERIHEALTH ADMINISTRADOR | OTHER | 0380903 | 05 | NJ | MEDICAID | 694258 | 01 | NJ | CIGNA | OTHER | 0073540000 | 01 | NJ | AMERIHEALTH | OTHER | 480020688 | 01 | NJ | RAIL ROAD MEDICARE | OTHER | 23332 | 01 | NJ | AMERIGROUP | OTHER | JP039 | 01 | NJ | OXFORD | OTHER |