Provider Demographics
NPI:1194935056
Name:STALEK, REBECCA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANN
Last Name:STALEK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:850 FULTON ST
Mailing Address - Street 2:SUITE2
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3649
Mailing Address - Country:US
Mailing Address - Phone:516-845-1600
Mailing Address - Fax:516-845-5610
Practice Address - Street 1:850 FULTON ST
Practice Address - Street 2:SUITE2
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3649
Practice Address - Country:US
Practice Address - Phone:516-845-1600
Practice Address - Fax:516-845-5610
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2013-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY252711207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine