Provider Demographics
NPI:1962464313
Name:REHBERG, ROBB S (PHD, ATC, CSCS, EMT)
Entity Type:Individual
Prefix:DR
First Name:ROBB
Middle Name:S
Last Name:REHBERG
Suffix:
Gender:M
Credentials:PHD, ATC, CSCS, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MATILDA TER
Mailing Address - Street 2:
Mailing Address - City:TOWACO
Mailing Address - State:NJ
Mailing Address - Zip Code:07082-1012
Mailing Address - Country:US
Mailing Address - Phone:973-720-2267
Mailing Address - Fax:
Practice Address - Street 1:300 POMPTON RD -
Practice Address - Street 2:WIGHTMAN GYMNASIUM WILLIAM PATERSON UNIVERSITY
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-720-2267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ146N00000X
NJ25MT00004342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic