Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 25MB09327300 | NJ |
NPI | 1265743967 |
---|---|
Provider Name | Dr. Benjamin Harrison Rebein |
First Address | Paterson, NJ 07503-2621 |
Second Address | Paterson, NJ 07503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2010 |
Last Update Date | 27/07/2016 |