Provider Demographics
NPI:1124212535
Name:HORN, REBECCA B (REBECCA HORN)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:B
Last Name:HORN
Suffix:
Gender:F
Credentials:REBECCA HORN
Other - Prefix:
Other - First Name:BECCA
Other - Middle Name:
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REBECCA HORN
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 313
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8004
Mailing Address - Country:US
Mailing Address - Phone:215-938-3413
Mailing Address - Fax:215-938-3422
Practice Address - Street 1:1648 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8001
Practice Address - Country:US
Practice Address - Phone:215-938-3413
Practice Address - Fax:215-938-3422
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430074207L00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102850311Medicaid