Healthcare Provider Details

I. General information

NPI: 1942422043
Provider Name (Legal Business Name): REBECCA KASSAPIAN BSC. R.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 JOG RD
DELRAY BEACH FL
33446-2321
US

IV. Provider business mailing address

23153 SW 53RD AVE
BOCA RATON FL
33433-7997
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-0000
  • Fax:
Mailing address:
  • Phone: 561-756-7037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT12674
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: