Healthcare Provider Details

I. General information

NPI: 1275852022
Provider Name (Legal Business Name): REBECCA ROMANO BESCH MS, ATC, PES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 MILITARY RD
KENMORE NY
14217-1339
US

IV. Provider business mailing address

1495 MILITARY RD
KENMORE NY
14217-1339
US

V. Phone/Fax

Practice location:
  • Phone: 716-462-9245
  • Fax:
Mailing address:
  • Phone: 716-462-9245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000857-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: