Provider Demographics
NPI:1134573884
Name:NEWHOUSE, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 WADSWORTH AVE
Mailing Address - Street 2:APT 4K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2505
Mailing Address - Country:US
Mailing Address - Phone:917-733-6631
Mailing Address - Fax:
Practice Address - Street 1:247 WADSWORTH AVE
Practice Address - Street 2:APT 4K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-2505
Practice Address - Country:US
Practice Address - Phone:917-733-6631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020509225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics