Healthcare Provider Details

I. General information

NPI: 1467148718
Provider Name (Legal Business Name): REBECCA BEVERLY KOW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

12801 SW 96TH AVE
MIAMI FL
33176-5753
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-5437
  • Fax:
Mailing address:
  • Phone: 469-525-0957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: