Provider Demographics
NPI:1558986067
Name:PADERSKY, REBECCA ANNE (MS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:PADERSKY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 1ST ST APT 706
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-5877
Mailing Address - Country:US
Mailing Address - Phone:856-630-9614
Mailing Address - Fax:
Practice Address - Street 1:210 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6047
Practice Address - Country:US
Practice Address - Phone:646-858-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS