Provider Demographics
NPI:1821383449
Name:TOPHAM, REBECCA (FNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TOPHAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BURWELL ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-1725
Mailing Address - Country:US
Mailing Address - Phone:315-823-1000
Mailing Address - Fax:315-823-4760
Practice Address - Street 1:140 BURWELL ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NY
Practice Address - Zip Code:13365-1725
Practice Address - Country:US
Practice Address - Phone:315-823-1000
Practice Address - Fax:315-823-4760
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily