Provider Demographics
NPI:1033362579
Name:MILES, REBECCA HYDE (PT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:HYDE
Last Name:MILES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13 COPPERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12188-1093
Mailing Address - Country:US
Mailing Address - Phone:518-424-8817
Mailing Address - Fax:518-233-1420
Practice Address - Street 1:13 COPPERFIELD DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:NY
Practice Address - Zip Code:12188-1093
Practice Address - Country:US
Practice Address - Phone:518-424-8817
Practice Address - Fax:518-233-1420
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010073-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics