Healthcare Provider Details

I. General information

NPI: 1326843129
Provider Name (Legal Business Name): REBECCA VARSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 HYLAN BLVD STE 2
STATEN ISLAND NY
10306-3515
US

IV. Provider business mailing address

1975 HYLAN BLVD STE 2
STATEN ISLAND NY
10306-3515
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-0012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065574
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: