Basic Information
Provider Information
NPI: 1700824273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REINSTEIN
FirstName: LEON
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2401 W BELVEDERE AVE
Address2: ATTN: CREDENTIALING
City: BALTIMORE
State: MD
PostalCode: 212155216
CountryCode: US
TelephoneNumber: 4106015524
FaxNumber: 4106018946
Practice Location
Address1: 2401 W BELVEDERE AVE
Address2: DEPT OF REHAB MEDICINE
City: BALTIMORE
State: MD
PostalCode: 212155216
CountryCode: US
TelephoneNumber: 4106015923
FaxNumber: 4106016071
Other Information
ProviderEnumerationDate: 06/04/2006
LastUpdateDate: 04/23/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000XD02555MDY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

ID Information
IDTypeStateIssuerDescription
02819130005MD MEDICAID
CA837401MDR/R MEDICARE GROUP #OTHER
25000617801MDR/R MEDICARE PROVIDER #OTHER


Home