Provider Demographics
NPI:1033641980
Name:PATEL, REBECCA SUSSMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SUSSMAN
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:HOPE
Other - Last Name:SUSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10285 TIMBERLINE VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-6573
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8380
Practice Address - Country:US
Practice Address - Phone:702-629-6992
Practice Address - Fax:702-441-6105
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV24572208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation