Provider Demographics
NPI:1316535982
Name:LALIBERTE, REBECCA (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LALIBERTE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:330 BORTHWICK AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7109
Mailing Address - Country:US
Mailing Address - Phone:603-431-5205
Mailing Address - Fax:
Practice Address - Street 1:330 BORTHWICK AVE STE 303
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7109
Practice Address - Country:US
Practice Address - Phone:603-431-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2022-04-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant