Provider Demographics
NPI:1154545572
Name:PLACELLA, REBECCA MARTIN (MPT)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MARTIN
Last Name:PLACELLA
Suffix:
Gender:F
Credentials:MPT
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Mailing Address - Street 1:13704 HARVEST GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-6250
Mailing Address - Country:US
Mailing Address - Phone:301-938-7915
Mailing Address - Fax:410-431-7042
Practice Address - Street 1:877 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4700
Practice Address - Country:US
Practice Address - Phone:410-431-7040
Practice Address - Fax:410-431-7042
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD19284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD180P418GMedicare PIN