Provider Demographics
NPI:1043277668
Name:REHRIG, ROSALEE K (DO)
Entity type:Individual
Prefix:
First Name:ROSALEE
Middle Name:K
Last Name:REHRIG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1976 WEST PENN PIKE
Mailing Address - Street 2:
Mailing Address - City:NEW RINGGOLD
Mailing Address - State:PA
Mailing Address - Zip Code:17960
Mailing Address - Country:US
Mailing Address - Phone:570-386-8861
Mailing Address - Fax:570-386-8862
Practice Address - Street 1:1976 WEST PENN PIKE
Practice Address - Street 2:
Practice Address - City:NEW RINGGOLD
Practice Address - State:PA
Practice Address - Zip Code:17960
Practice Address - Country:US
Practice Address - Phone:570-386-8861
Practice Address - Fax:570-386-8862
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 011171L207Q00000X
PAOS-011171-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019555400001Medicaid
PA1019671310001Medicaid
PAH83306Medicare UPIN
PA1019671310001Medicaid