Provider Demographics
NPI:1760005086
Name:TUCHMAN, REBECCA MIRIAM (AUD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MIRIAM
Last Name:TUCHMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 147TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2003
Mailing Address - Country:US
Mailing Address - Phone:917-370-6961
Mailing Address - Fax:
Practice Address - Street 1:7117 147TH ST APT A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2003
Practice Address - Country:US
Practice Address - Phone:917-370-6961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002921231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist