MEDICARE: DR. ROBERT JOSEPH RIETHMILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	8134	MA

General Provider Information

NPI Number	:	1083688493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOSEPH RIETHMILLER

Provider Business Mailing Address
First Line	:	1330 BEACON ST
Second Line	:	STE 314
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3202
Country	:	US
Telephone Number	:	617-738-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 BEACON ST
Second Line	:	STE 314
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3202
Country	:	US
Telephone Number	:	617-738-0100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	04/05/2016

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