Basic Information
| Provider Information | |||||||||
| NPI: | 1881960938 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REISINGER | ||||||||
| FirstName: | NATHANIEL | ||||||||
| MiddleName: | CANTEY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 CIVIC CENTER BOULEVARD | ||||||||
| Address2: | 1ST FLOOR SUITE 1-300S, SOUTH PAVILION | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191045161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622638 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3400 SPRUCE ST | ||||||||
| Address2: | GROUND SILVERSTEIN BLDG | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156626698 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2012 | ||||||||
| LastUpdateDate: | 02/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD458106 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207RN0300X | 25MA10297800 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | MD458106 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.