MEDICARE: REBECCA D LANSKY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	OT012622	PA
2	390200000X	Student in an Organized Health Care Education/Training Program	OT012622	PA
3	208100000X	Physical Medicine & Rehabilitation Physician	249190	MA

General Provider Information

NPI Number	:	1245494772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA D LANSKY DO

Provider Business Mailing Address
First Line	:	179 NORTHAMPTON ST
Second Line	:	# C1
City	:	EASTHAMPTON
State	:	MA
Zip	:	01027-1057
Country	:	US
Telephone Number	:	800-225-8885
Fax Number	:	508-334-1977

Provider Business Practice Location Address
First Line	:	179 NORTHAMPTON ST UNIT C-1
Second Line	:
City	:	EASTHAMPTON
State	:	MA
Zip	:	01027-1057
Country	:	US
Telephone Number	:	800-225-8885
Fax Number	:	508-334-1977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	05/25/2016

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