Individual
DR. BRUCE L REBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
87 COLD SPRING RD, SYOSSET, NY 11791-3109
(516) 921-3168
Mailing address
87 COLD SPRING RD, SYOSSET, NY 11791-3109
(516) 921-3168
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
136518
NY
207VX0000X
Obstetrics Physician
136518
NY
Other
Enumeration date
01/17/2007
Last updated
04/05/2012
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