Provider Demographics
NPI:1790066496
Name:LEWIN, REBECCA RACHEL
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RACHEL
Last Name:LEWIN
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 1:115 W 86TH ST
Mailing Address - Street 2:APT. 6D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3410
Mailing Address - Country:US
Mailing Address - Phone:917-453-5124
Mailing Address - Fax:
Practice Address - Street 1:115 W 86TH ST
Practice Address - Street 2:APT. 6D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3410
Practice Address - Country:US
Practice Address - Phone:917-453-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016211225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist