Basic Information
| Provider Information | |||||||||
| NPI: | 1285744706 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REINHARD | ||||||||
| FirstName: | KENNETH | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD,ABPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17 DAILEY DR | ||||||||
| Address2: | |||||||||
| City: | CROTON ON HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105203536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142713336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2094 ALBANY POST RD | ||||||||
| Address2: | RM. 133D | ||||||||
| City: | MONTROSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105481454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147374400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 007093 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.