Individual provider Active NPI

Ellen Reiner, PH.D.

  • Intellectual & Developmental Disabilities Psychologist
  • Waltham, MA
National Provider Identifier
1700062361
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
411 Waverly Oaks Rd
Building #3, Suite 305
Waltham, MA 02452-8448
Phone
(781) 894-6564
Fax
(781) 893-5938
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

411 Waverly Oaks Rd
Building #3, Suite 305
Waltham, MA 02452-8448

Mailing address

411 Waverly Oaks Rd
Building #3, Suite 305
Waltham, MA 02452-8448
Phone (781) 894-6564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1700062361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WAVERLY OAKS RD",
            "address_2": "BUILDING #3, SUITE 305",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528448",
            "telephone_number": "781-894-6564",
            "fax_number": "781-893-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WAVERLY OAKS RD",
            "address_2": "BUILDING #3, SUITE 305",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528448",
            "telephone_number": "781-894-6564",
            "fax_number": "781-893-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINER",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.