Provider Demographics
NPI:1770474041
Name:REBENCHUK, VALENTYNA
Entity type:Individual
Prefix:
First Name:VALENTYNA
Middle Name:
Last Name:REBENCHUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1556 W 8TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6503
Mailing Address - Country:US
Mailing Address - Phone:347-260-5252
Mailing Address - Fax:
Practice Address - Street 1:1556 W 8TH ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6503
Practice Address - Country:US
Practice Address - Phone:347-260-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCERTIFIED174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist