Provider Demographics
NPI:1447418694
Name:TINSMAN, REBECCA LIVEZEY (RPA C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LIVEZEY
Last Name:TINSMAN
Suffix:
Gender:F
Credentials:RPA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W 55TH ST
Mailing Address - Street 2:APT 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5132
Mailing Address - Country:US
Mailing Address - Phone:212-265-1153
Mailing Address - Fax:
Practice Address - Street 1:520 E. 70TH ST.
Practice Address - Street 2:NEW YORK-PRESBYTERIAN HOSPITAL, STARR 341
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-746-7576
Practice Address - Fax:212-746-8246
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005428363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant