Basic Information
| Provider Information | |||||||||
| NPI: | 1114085206 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REISS | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 MAMARONECK AVE STE 302 | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105281615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147238100 | ||||||||
| FaxNumber: | 9142191928 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 MAMARONECK AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105281635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147238100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 03/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 38719 | CT | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 132418-1 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 24A413 | 01 | NY | BLUE CROSS | OTHER | 1C8775 | 01 | HEALTHNET | OTHER | 160058889 | 01 | NY | RAILROAD MEDICARE | OTHER | WP212 | 01 | OXFORD HEALTH PLANS | OTHER | 24A411 | 01 | NY | BLUE CROSS | OTHER | 0018902 | 01 | GHI | OTHER | 24A412 | 01 | NY | BLUE CROSS | OTHER | 2594472 | 01 | CCN | OTHER | 716153 | 01 | FIRST HEALTH | OTHER |