Healthcare Provider Details

I. General information

NPI: 1376624429
Provider Name (Legal Business Name): ROBYNE G RAST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RUTHERFORD RD STE 101
HARRISBURG PA
17109-4500
US

IV. Provider business mailing address

1 RUTHERFORD RD STE 101
HARRISBURG PA
17109-4500
US

V. Phone/Fax

Practice location:
  • Phone: 717-545-5256
  • Fax: 717-545-5259
Mailing address:
  • Phone: 717-545-5256
  • Fax: 717-545-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME61649
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD433237
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: