Provider Demographics
NPI:1477640837
Name:REHBERG, JOELLE STABILE (DO)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:STABILE
Last Name:REHBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MADISON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6967
Mailing Address - Country:US
Mailing Address - Phone:973-285-7800
Mailing Address - Fax:973-285-7839
Practice Address - Street 1:310 MADISON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6967
Practice Address - Country:US
Practice Address - Phone:973-285-7800
Practice Address - Fax:973-285-7839
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06988300207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0093386Medicaid
NJ052470Medicare PIN
NJH54128Medicare UPIN