Provider Demographics
NPI:1992241848
Name:REBECCA HORNE PEDIATRICS, LLC
Entity type:Organization
Organization Name:REBECCA HORNE PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-232-2915
Mailing Address - Street 1:1180 BEACON ST
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3885
Mailing Address - Country:US
Mailing Address - Phone:781-859-8828
Mailing Address - Fax:617-232-2337
Practice Address - Street 1:1180 BEACON ST
Practice Address - Street 2:SUITE 7A
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3885
Practice Address - Country:US
Practice Address - Phone:781-859-8828
Practice Address - Fax:617-232-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245180208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty