| Michael J Reiss Psyd Llc | |
|
200a Oak St Glastonbury CT 06033-2320 | |
| (860) 657-8868 | |
| Not Available |
| Full Name | Michael J Reiss Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 200a Oak St, Glastonbury, Connecticut |
| Authorized Official Name and Position | Michael J Reiss (PSYCHOLOGIST) |
| Authorized Official Contact | 8606578868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Reiss Psyd Llc 200a Oak St Glastonbury CT 06033-2320 Ph: (860) 657-8868 | Michael J Reiss Psyd Llc 200a Oak St Glastonbury CT 06033-2320 Ph: (860) 657-8868 |
| NPI Number | 1205304805 |
|---|---|
| Provider Enumeration Date | 11/13/2018 |
| Last Update Date | 07/23/2020 |
| Certification Date | 07/23/2020 |
| Medicare PECOS PAC ID | 8426393232 |
|---|---|
| Medicare Enrollment ID | O20181226001421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205304805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michael J Reiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740737139 PECOS PAC ID: 6800130758 Enrollment ID: I20181203002934 |
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