Individual
LISE REHWALDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1176 5TH AVE, E LEVEL, NEW YORK, NY 10029-6503
(212) 659-8557
Mailing address
1176 5TH AVE, E LEVEL, NEW YORK, NY 10029-6503
(212) 659-8557
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
187405
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01653841
—
NY
Enumeration date
09/20/2006
Last updated
03/14/2012
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