Provider Demographics
NPI:1811270549
Name:PARE, REBECCA ANNE (NP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:PARE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 BROADWAY RM 1313
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2754
Mailing Address - Country:US
Mailing Address - Phone:914-919-9200
Mailing Address - Fax:
Practice Address - Street 1:61 BROADWAY RM 1313
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2754
Practice Address - Country:US
Practice Address - Phone:914-919-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23643363LX0001X
NH058131-23363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology