Healthcare Provider Details

I. General information

NPI: 1154737922
Provider Name (Legal Business Name): REBECCA STREET DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PERFORMANCE DR
WEYMOUTH MA
02189-3141
US

IV. Provider business mailing address

147 TOWNE SQUARE WAY
PITTSBURGH PA
15227-3254
US

V. Phone/Fax

Practice location:
  • Phone: 781-682-5000
  • Fax:
Mailing address:
  • Phone: 412-942-1085
  • Fax: 412-942-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101021434
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1024633
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS020145
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: