Provider Demographics
NPI:1164948212
Name:ROBEL, REBECCA MORGAN (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MORGAN
Last Name:ROBEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0699
Mailing Address - Country:US
Mailing Address - Phone:585-582-6085
Mailing Address - Fax:585-582-1128
Practice Address - Street 1:274 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1157
Practice Address - Country:US
Practice Address - Phone:585-924-3250
Practice Address - Fax:585-924-5127
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042055225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist