Doctor Name: | KENDRA SUZANNE REISNER |
NPI Number: | 1053637173 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 1907 Lebanon Church Rd Suite 201 West Mifflin, PA - 151222432 |
Business Phone Number: | 4126538500 |
Business Fax Number: | 4126538515 |
Mailing Address: | 11279 Perry Hwy, Suite 450 WEXFORD |
State: | PA |
Postal Code: | 150909381 |
Phone Number: | 7249331100 |
Fax Number: | 7249331160 |
NPI Enumeration Date: | 04/14/2010 |
NPI Last Update Date: | 06/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |