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General NPI Number Information
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NPI Number | 1124849419
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Entity Type | Individual
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Provider Name | REBEKAH GAMBLE
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1106 REVEREND JAMES AVE POLITE SUITE 5
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City | BRONX
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State | NY
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Zip | 10459
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Country | US
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Telephone | 347-744-9052
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Fax |
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Provider Business Mailing Address
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Address Line | 855 E 178TH ST APT 2D
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City | BRONX
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State | NY
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Zip | 10460-6126
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Country | US
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Telephone | 917-594-2997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 033700
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License Number State | NY
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