Provider Demographics
NPI:1124555370
Name:MATTA, REBEKAH BARBARA
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:BARBARA
Last Name:MATTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 MCCASLIN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2629
Mailing Address - Country:US
Mailing Address - Phone:412-521-6989
Mailing Address - Fax:
Practice Address - Street 1:51 WEST COLLEGE ST.
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370
Practice Address - Country:US
Practice Address - Phone:800-225-7393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer