Provider Demographics
NPI:1144350554
Name:REIMER, SYLVIA JEAN (MD)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:JEAN
Last Name:REIMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22325 RIVERBEND DR E
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-1723
Mailing Address - Country:US
Mailing Address - Phone:315-788-5442
Mailing Address - Fax:315-788-7048
Practice Address - Street 1:137 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642-1427
Practice Address - Country:US
Practice Address - Phone:315-287-2285
Practice Address - Fax:315-287-1824
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150066-1207V00000X
GA051721207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00583697Medicaid
NYRA4530Medicare PIN
NY00583697Medicaid