Healthcare Provider Details

I. General information

NPI: 1215692991
Provider Name (Legal Business Name): REBECCA Y WINT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 SNOWDRIFT RD
ALLENTOWN PA
18106-9395
US

IV. Provider business mailing address

365 OCEAN BLVD UNIT 302
LONG BRANCH NJ
07740-6097
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 732-233-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00768600
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: