Provider Demographics
NPI:1619015765
Name:WINSTON, REBECCA NATALIE (OT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:NATALIE
Last Name:WINSTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FORTUNE LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2314
Mailing Address - Country:US
Mailing Address - Phone:516-935-6770
Mailing Address - Fax:516-935-6805
Practice Address - Street 1:31 FORTUNE LN
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2314
Practice Address - Country:US
Practice Address - Phone:516-935-6770
Practice Address - Fax:516-935-6805
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006823-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics