Provider Demographics
NPI:1710610209
Name:RHEIN, MARISA (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:RHEIN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:
Other - Last Name:RAPISARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:130 GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1740
Mailing Address - Country:US
Mailing Address - Phone:201-566-5549
Mailing Address - Fax:
Practice Address - Street 1:130 GLENN AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1740
Practice Address - Country:US
Practice Address - Phone:201-566-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18862000163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant