Provider Demographics
NPI:1144558123
Name:RIEHL, JAMES-LESLIE S JR (PT)
Entity type:Individual
Prefix:
First Name:JAMES-LESLIE
Middle Name:S
Last Name:RIEHL
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 W 231ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3940
Mailing Address - Country:US
Mailing Address - Phone:718-548-1212
Mailing Address - Fax:718-514-6120
Practice Address - Street 1:280 W 231ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3940
Practice Address - Country:US
Practice Address - Phone:718-548-1212
Practice Address - Fax:718-514-6120
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
029342OtherLICENSE