Basic Information
| Provider Information | |||||||||
| NPI: | 1417367657 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REICHBIND | ||||||||
| FirstName: | JESSICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1351 WASHINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069022419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032761000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064222130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603585020 | ||||||||
| FaxNumber: | 8603588652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2014 | ||||||||
| LastUpdateDate: | 02/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 52253 | CT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.