NPIMap

Organization Active NPI

Reiswig Aesthetics SC

  • Health Service Clinic/Center
  • Wauwatosa, WI
National Provider Identifier
1417370602
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
52720-20 Issued in WI
Legal business name
REISWIG AESTHETICS SC
Practice address
1233 N Mayfair Rd Ste 208
Wauwatosa, WI 53226-3255
Phone
(414) 526-1291
NPI assigned
Jan 24, 2014
Last updated
Apr 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Amanda Reiswig, M.D.NPI 1144492273
Title
Owner/Physician
Phone
(414) 526-1291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 52720-20 WI Primary

Addresses

Primary practice location

1233 N Mayfair Rd Ste 208
Wauwatosa, WI 53226-3255

Mailing address

1233 N Mayfair Rd Ste 208
Wauwatosa, WI 53226-3255
Phone (414) 526-1291

National Provider Directory

National Provider Directory

Locations

1233 N Mayfair Rd
Ste 208
Wauwatosa, WI 53226
Phone (414) 526-1291

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1417370602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 N MAYFAIR RD STE 208",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263255",
            "telephone_number": "414-526-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 N MAYFAIR RD STE 208",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263255",
            "telephone_number": "414-526-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REISWIG AESTHETICS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "REISWIG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "414-526-1291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WI",
            "license": "52720-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.