Basic Information
Provider Information
NPI: 1407888522
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REINHARDT
FirstName: THOMAS
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 187 MILLBURN AVE
Address2: STE 110
City: MILLBURN
State: NJ
PostalCode: 07041
CountryCode: US
TelephoneNumber: 9734677976
FaxNumber: 9734677971
Practice Location
Address1: 484 SOUTHERN BLVD
Address2:  
City: CHATHAM
State: NJ
PostalCode: 07928
CountryCode: US
TelephoneNumber: 9733775990
FaxNumber: 9733775996
Other Information
ProviderEnumerationDate: 07/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XQAO2750NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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