Provider Demographics
NPI:1144299694
Name:POINTEK, REBEKAH VENEZIA (APRN)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:VENEZIA
Last Name:POINTEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:REBEKAH
Other - Middle Name:VENEZIA
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PRIME HEALTHCARE PC
Mailing Address - Street 2:30 JORDAN LN
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1278
Mailing Address - Country:US
Mailing Address - Phone:860-263-0253
Mailing Address - Fax:860-263-0262
Practice Address - Street 1:20 ISHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2204
Practice Address - Country:US
Practice Address - Phone:860-247-2530
Practice Address - Fax:860-524-7727
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310695363LA2200X
MARN2374807363LA2200X
CT003165363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q47080Medicare UPIN
CTS00001499Medicare ID - Type Unspecified