Provider Demographics
NPI:1336120781
Name:TINSMAN, REBECCA SUSAN (PT, OCS)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:SUSAN
Last Name:TINSMAN
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 FOX HUNT DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2536
Mailing Address - Country:US
Mailing Address - Phone:302-834-8650
Mailing Address - Fax:302-834-8698
Practice Address - Street 1:256 FOX HUNT DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2536
Practice Address - Country:US
Practice Address - Phone:302-834-8650
Practice Address - Fax:302-834-8698
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10001454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG00716Medicare PIN
DE133887ZBSXMedicare PIN