Provider Demographics
NPI:1184402059
Name:SENDEROVITS, REBECCA (RN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SENDEROVITS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 N LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1666
Mailing Address - Country:US
Mailing Address - Phone:908-670-2209
Mailing Address - Fax:
Practice Address - Street 1:1211 N LAKE DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1666
Practice Address - Country:US
Practice Address - Phone:908-670-2209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY587182-1163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory