Rebecca Lynn Kirshak

Primary specialty

SpecialistTaxonomy code 174400000X

License

554803 Issued in NY

Practice address

11 Astor Ave
Brookhaven, NY 11719-9760

Phone

(631) 905-9086

NPI assigned

Jun 17, 2012

Last updated

Jun 17, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339891200000",
    "number": "1982967881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ASTOR AVE",
            "city": "BROOKHAVEN",
            "state": "NY",
            "postal_code": "117199760",
            "telephone_number": "631-905-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ASTOR AVE",
            "city": "BROOKHAVEN",
            "state": "NY",
            "postal_code": "117199760",
            "telephone_number": "631-905-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSHAK",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2012-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "554803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Brookhaven, NY
• Providers in Brookhaven, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.