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General NPI Number Information
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NPI Number | 1487926507
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Entity Type | Individual
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Provider Name | MICHAEL HARRY REHAL PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/05/2012
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 200 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3006
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Country | US
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Telephone | 570-839-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 50 CRYSTAL ST APARTMENT 303
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-2848
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Country | US
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Telephone |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA055220
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License Number State | PA
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