Provider Demographics
NPI:1407886617
Name:BRICKMAN, REBECCA E (DPM)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:E
Last Name:BRICKMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 PRINCE CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2119
Mailing Address - Country:US
Mailing Address - Phone:914-525-0015
Mailing Address - Fax:
Practice Address - Street 1:7808 PACIFIC AVE 1
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7039
Practice Address - Country:US
Practice Address - Phone:253-473-5566
Practice Address - Fax:253-473-6436
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006195213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8431199Medicaid
WA199496OtherLABOR & INDUSTRIES
WA8431199Medicaid
V05137Medicare UPIN