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General NPI Number Information
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NPI Number | 1730053091
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Entity Type | Individual
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Provider Name | REBECCA VAETH
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Gender | Female
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 340 DOGWOOD AVE STE 101
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3400
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Country | US
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Telephone | 516-565-2018
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Fax |
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Provider Business Mailing Address
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Address Line | 14 BARCLAY ST
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-2619
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Country | US
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Telephone |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 064881
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License Number State | NY
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