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General NPI Number Information
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NPI Number | 1093031908
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Entity Type | Individual
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Provider Name | REBECCA MARIA GRUTSCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 405 BETHEL RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2108
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Country | US
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Telephone | 732-945-3921
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Fax |
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Provider Business Mailing Address
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Address Line | 655 SHREWSBURY AVE
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4179
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Country | US
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Telephone | 732-945-3921
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 62309
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036.138456
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 62309
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 036.138456
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA10638300
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License Number State | NJ
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