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NPI Code Detail

MEDICARE: REBECCA ANN FOWLES OT

MEDICARE: REBECCA ANN FOWLES OT
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
1225X00000XOccupational Therapist007487-1NY

General Provider Information

NPI Number : 1780835074
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ANN FOWLES OT
Provider Business Mailing Address
First Line : 3131 GRAND CONCOURSE APT 3C
Second Line :
City : BRONX
State : NY
Zip : 10468-1404
Country : US
Telephone Number : 718-584-5130
Fax Number : 718-584-5130
Provider Business Practice Location Address
First Line : 3131 GRAND CONCOURSE APT 3C
Second Line :
City : BRONX
State : NY
Zip : 10468-1404
Country : US
Telephone Number : 718-584-5130
Fax Number : 718-584-5130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2008
Last Update Date : 10/05/2008

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Directions to “ REBECCA ANN FOWLES OT” Practice Location

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