Healthcare Provider Details

I. General information

NPI: 1386962785
Provider Name (Legal Business Name): ROBERT TODD RINNIER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2010
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COOPER PLZ
CAMDEN NJ
08103-1489
US

IV. Provider business mailing address

PO BOX 7776
LANCASTER PA
17601-7776
US

V. Phone/Fax

Practice location:
  • Phone: 856-342-2425
  • Fax: 856-968-8239
Mailing address:
  • Phone: 888-985-2727
  • Fax: 856-779-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MB08757700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number25MB08757700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: