Provider Demographics
NPI:1154761369
Name:STEWART, REBECCA CLAIRE (NP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CLAIRE
Last Name:STEWART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 DONATO CT
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-8116
Mailing Address - Country:US
Mailing Address - Phone:516-724-6898
Mailing Address - Fax:
Practice Address - Street 1:353 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0941
Practice Address - Country:US
Practice Address - Phone:917-391-0076
Practice Address - Fax:917-477-6849
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY430739363LA2100X
NY405479363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care