Healthcare Provider Details

I. General information

NPI: 1659900215
Provider Name (Legal Business Name): REBECCA T HSU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CIVIC CENTER BLVD FL 2
PHILADELPHIA PA
19104-5127
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD FL 2
PHILADELPHIA PA
19104-5127
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-3606
  • Fax: 215-662-3362
Mailing address:
  • Phone: 215-662-3606
  • Fax: 215-662-3362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberMD484274
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: