Provider Demographics
NPI:1265748172
Name:BOBELDYK, REBEKAH (DPT)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:BOBELDYK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3034
Mailing Address - Country:US
Mailing Address - Phone:781-455-6661
Mailing Address - Fax:
Practice Address - Street 1:175 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3034
Practice Address - Country:US
Practice Address - Phone:781-455-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00898835OtherMEDICARE RAILROAD
ILP00898835OtherMEDICARE RAILROAD