Provider Demographics
NPI:1710722152
Name:NICHOLAS, REBECCA SPENSER (MBBS, FRCS, EBHS, BS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SPENSER
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:MBBS, FRCS, EBHS, BS
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:SPENSER
Other - Last Name:FURLONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 WEST 15TH STREET
Mailing Address - Street 2:605
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:646-939-0206
Mailing Address - Fax:
Practice Address - Street 1:330 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-369-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3262612086S0105X, 2082S0099X, 2086S0122X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery