Provider Demographics
NPI:1578199568
Name:FAY, REBEKAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:FAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 PEACOCK AVE APT 721
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2872
Mailing Address - Country:US
Mailing Address - Phone:607-972-3002
Mailing Address - Fax:
Practice Address - Street 1:3737 PEACOCK AVE APT 721
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-2872
Practice Address - Country:US
Practice Address - Phone:607-972-3002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist