Provider Demographics
NPI:1053672667
Name:REBELO, TONI - ANN T (MSN, ANP)
Entity Type:Individual
Prefix:MRS
First Name:TONI - ANN
Middle Name:T
Last Name:REBELO
Suffix:
Gender:F
Credentials:MSN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MAIN ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3335
Mailing Address - Country:US
Mailing Address - Phone:781-438-9600
Mailing Address - Fax:781-438-9601
Practice Address - Street 1:2 MAIN ST
Practice Address - Street 2:SUITE 150
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3335
Practice Address - Country:US
Practice Address - Phone:781-438-9600
Practice Address - Fax:781-438-9601
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN264408163WR1000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility