Provider Demographics
NPI:1003085267
Name:WEBB, REBECCA LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:WEBB
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:6508A BASILE ROWE
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-2942
Mailing Address - Country:US
Mailing Address - Phone:315-433-2300
Mailing Address - Fax:315-433-5300
Practice Address - Street 1:2949 ERIE BLVD E
Practice Address - Street 2:SUITE 103
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1442
Practice Address - Country:US
Practice Address - Phone:315-425-8028
Practice Address - Fax:315-425-0989
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist