Provider Demographics
NPI:1578272688
Name:WOROBEY, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WOROBEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13452-1127
Mailing Address - Country:US
Mailing Address - Phone:518-568-0032
Mailing Address - Fax:518-568-0035
Practice Address - Street 1:30 CENTER ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13452-1127
Practice Address - Country:US
Practice Address - Phone:518-568-0032
Practice Address - Fax:518-568-0035
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist