MEDICARE: DR. REBECCA R CAMPBELL PT, DPT

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	225100000X	Physical Therapist	031050-1	NY

General Provider Information

NPI Number	:	1942445499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA R CAMPBELL PT, DPT

Provider Business Mailing Address
First Line	:	500 SENECA ST APT 4-18
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14204-1990
Country	:	US
Telephone Number	:	330-651-5252
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 SENECA ST APT 4-18
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14204-1990
Country	:	US
Telephone Number	:	330-651-5252
Fax Number	:

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

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	01/10/2020

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