Provider Demographics
NPI:1811323496
Name:LEFCHAK, REBECCA TERRY (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:TERRY
Last Name:LEFCHAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2527
Mailing Address - Country:US
Mailing Address - Phone:609-838-0871
Mailing Address - Fax:
Practice Address - Street 1:211 LOWELL AVE
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-2527
Practice Address - Country:US
Practice Address - Phone:609-838-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00966300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist