Healthcare Provider Details

I. General information

NPI: 1447418694
Provider Name (Legal Business Name): REBECCA LIVEZEY TINSMAN RPA C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E. 70TH ST. NEW YORK-PRESBYTERIAN HOSPITAL, STARR 341
NEW YORK NY
10022
US

IV. Provider business mailing address

310 W 55TH ST APT 2A
NEW YORK NY
10019-5132
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-7576
  • Fax: 212-746-8246
Mailing address:
  • Phone: 212-265-1153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number005428
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: