Most Relevant Information
Provider Data
| NPI Number: | 1003552266 |
| Provider Name: | ANDREW REISSIG PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 40QB00196400 |
Most Important Dates
| Enumeration Date: | 05/10/2022 |
| Last Updated: | 05/10/2022 |
Provider Practice Location
301 SICOMAC AVE
WYCKOFF
NJ
074812159
Practice Location Phone/Fax
| Phone: | 2018245624 |
| Fax: |
Provider Mailing Location
64 E JOHNSON AVE
BERGENFIELD
NJ
076211817
Provider Mailing Phone/Fax
| Phone: | 2012208061 |
| Fax: |