Provider Demographics
NPI:1265081525
Name:RACZ, REBEKA (WHNP)
Entity type:Individual
Prefix:
First Name:REBEKA
Middle Name:
Last Name:RACZ
Suffix:
Gender:
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-6589
Mailing Address - Country:US
Mailing Address - Phone:917-410-6905
Mailing Address - Fax:646-878-6095
Practice Address - Street 1:535 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6589
Practice Address - Country:US
Practice Address - Phone:917-410-6905
Practice Address - Fax:646-878-6095
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421407363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health