1710123013 NPI number — DR. TODD JAMES REHM D.O.

Table of content: DR. TODD JAMES REHM D.O. (NPI 1710123013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710123013 NPI number — DR. TODD JAMES REHM D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REHM
Provider First Name:
TODD
Provider Middle Name:
JAMES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710123013
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2309 RT 9N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE GEORGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-668-2222
Provider Business Mailing Address Fax Number:
518-668-5307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2309 ROUTE 9N
Provider Second Line Business Practice Location Address:
REHM CHIROPRACTIC & MASSAGE CLINIC2309
Provider Business Practice Location Address City Name:
LAKE GEORGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-668-2222
Provider Business Practice Location Address Fax Number:
518-668-5307
Provider Enumeration Date:
12/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  X0083531 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)