Healthcare Provider Details

I. General information

NPI: 1689998106
Provider Name (Legal Business Name): ROBERT E REBER M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 LAFAYETTE PL 301
GREENWICH CT
06830-5426
US

IV. Provider business mailing address

77 LAFAYETTE PL 301
GREENWICH CT
06830-5426
US

V. Phone/Fax

Practice location:
  • Phone: 203-863-4300
  • Fax: 203-863-4310
Mailing address:
  • Phone: 203-863-4300
  • Fax: 203-863-4310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E REBER
Title or Position: OWNER
Credential: M.D.
Phone: 203-863-4300