Healthcare Provider Details

I. General information

NPI: 1346164795
Provider Name (Legal Business Name): REBECCA MICHELE PAUL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 5TH AVE FL 11
NEW YORK NY
10001-8017
US

IV. Provider business mailing address

220 5TH AVE FL 11
NEW YORK NY
10001-8017
US

V. Phone/Fax

Practice location:
  • Phone: 646-522-9714
  • Fax:
Mailing address:
  • Phone: 929-223-7449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408962
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: