Provider Demographics
NPI:1932167020
Name:ODORIZZI, REBECCA JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JEAN
Last Name:ODORIZZI
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:241 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-4302
Practice Address - Country:US
Practice Address - Phone:570-225-7211
Practice Address - Fax:570-225-7221
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013501207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101794497-0027Medicaid