Provider Demographics
NPI:1548346844
Name:REHNSTROM, JAANA VIVECA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JAANA
Middle Name:VIVECA
Last Name:REHNSTROM
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:JAANA
Other - Middle Name:
Other - Last Name:REHNSTROM-BLANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:44A MORTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4021
Mailing Address - Country:US
Mailing Address - Phone:212-242-8747
Mailing Address - Fax:
Practice Address - Street 1:103 5TH AVE
Practice Address - Street 2:3RD FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1009
Practice Address - Country:US
Practice Address - Phone:212-366-4765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167336207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64230Medicare UPIN
NY77D281Medicare ID - Type Unspecified