Provider Demographics
NPI:1710951264
Name:LIM, REBECCA BELLO (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:BELLO
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:570-882-3007
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-888-5858
Practice Address - Fax:570-882-3007
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD034118L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00686897Medicaid
PACC9269OtherRR MEDICARE GROUP
PA0008077670001Medicaid
NY00686897Medicaid
D12617Medicare UPIN