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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GENE CASAMERA REAVIS III, CO

Active Sole Proprietor

GENE CASAMERA REAVIS III, CO is a Prosthetic/Orthotic Supplier healthcare provider located in PHILA, Pennsylvania. NPI 1659150696 is currently active in the NPPES registry. Verify at CMS.

Prosthetic/Orthotic Supplier · PHILA, PA

Registration Details

NPI Number
1659150696
Provider Type
Individual
Gender
Male
NPI Issued
Sep 28, 2023 (2.899572179378 yrs)
Last Updated
Sep 28, 2023
License
CO264177 (PA)
Sole Proprietor
Yes

Practice Information

Address
901 S 55TH ST UNIT A2
PHILA, PA, 191434005
Browse PA providers · Browse ZIP 19143
Phone
2154744767
Primary Specialty
Prosthetic/Orthotic Supplier
335E00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.