Provider Demographics
NPI:1215003769
Name:YURKO, REBECCA ANN (MPT)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:YURKO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MAIN ST
Mailing Address - Street 2:GEM-RIVERSIDE REHAB
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-1604
Mailing Address - Country:US
Mailing Address - Phone:570-674-2659
Mailing Address - Fax:570-675-8980
Practice Address - Street 1:26 MAIN ST
Practice Address - Street 2:GEM-RIVERSIDE REHAB
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-1604
Practice Address - Country:US
Practice Address - Phone:570-674-2659
Practice Address - Fax:570-675-8980
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011699L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1523082OtherBLUE SHIELD
445265OtherHEALTH AMERICA ASSURANCE
352331OtherHEALTH AMERICA ASSURANCE
815884OtherFIRST PRIORITY
442566OtherHEALTH AMERICA ASSURANCE
818046OtherFIRST PRIORITY
818045OtherFIRST PRIORITY