MEDICARE: DR. REBEKAH LEIGH RUPPE CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	F001040	NY
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	F360466	NY

General Provider Information

NPI Number	:	1730393950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBEKAH LEIGH RUPPE CNM

Provider Business Mailing Address
First Line	:	4746 40TH ST APT 2C
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-4047
Country	:	US
Telephone Number	:	347-675-2072
Fax Number	:	212-305-6937

Provider Business Practice Location Address
First Line	:	617 W 168TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3703
Country	:	US
Telephone Number	:	212-305-6994
Fax Number	:	212-305-6937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	10/09/2012

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