Individual
TIFFANY L. REBELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051-2810
(262) 251-7500
(262) 251-7128
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
46467
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34490400
—
WI
01
—
P00612842
RR MEDICARE
WI
Enumeration date
06/26/2006
Last updated
04/17/2025
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