Provider Demographics
NPI:1891411369
Name:WOLIN, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WOLIN
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:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:MA
Mailing Address - Zip Code:01245-0485
Mailing Address - Country:US
Mailing Address - Phone:203-858-5109
Mailing Address - Fax:
Practice Address - Street 1:320 BEARTOWN MOUNTAIN RD
Practice Address - Street 2:485
Practice Address - City:MONTEREY
Practice Address - State:MA
Practice Address - Zip Code:01245-0124
Practice Address - Country:US
Practice Address - Phone:203-858-5109
Practice Address - Fax:203-858-5109
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist