Provider Demographics
NPI:1154754042
Name:NORSWORTHY, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NORSWORTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WEST AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6045
Mailing Address - Country:US
Mailing Address - Phone:518-583-7537
Mailing Address - Fax:
Practice Address - Street 1:1 WEST AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6045
Practice Address - Country:US
Practice Address - Phone:518-583-7537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036723-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist