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: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W END AVE
NEW YORK NY
10023-7839
US

IV. Provider business mailing address

12801 SW 96TH AVE
MIAMI FL
33176-5753
US

V. Phone/Fax

Practice location:
  • Phone: 212-315-8233
  • Fax: 212-315-8234
Mailing address:
  • Phone: 469-525-0957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number343995
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: