Provider Demographics
NPI:1700237799
Name:DESIMONE, REBECCA (DPM)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DESIMONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9627
Mailing Address - Country:US
Mailing Address - Phone:717-757-3537
Mailing Address - Fax:
Practice Address - Street 1:2300 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9627
Practice Address - Country:US
Practice Address - Phone:717-757-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006776213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist