Provider Demographics
NPI:1952602989
Name:REGO, REBECA MARIA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECA
Middle Name:MARIA
Last Name:REGO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MARGO CT
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10901-7506
Mailing Address - Country:US
Mailing Address - Phone:646-592-3791
Mailing Address - Fax:
Practice Address - Street 1:5 MARGO CT
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10901-7506
Practice Address - Country:US
Practice Address - Phone:646-592-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010909-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist