Provider Demographics
NPI:1811151970
Name:REHR, SUSAN RAE
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:RAE
Last Name:REHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 JACKIE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1047
Mailing Address - Country:US
Mailing Address - Phone:732-972-6174
Mailing Address - Fax:732-972-4230
Practice Address - Street 1:118 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-8018
Practice Address - Country:US
Practice Address - Phone:732-446-0945
Practice Address - Fax:732-446-5391
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA003859002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics