Provider Demographics
NPI:1699754747
Name:PAPPALARDO, REBECCA A (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:PAPPALARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28082
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5024
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-523-6121
Practice Address - Fax:212-763-9068
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191029207L00000X
NJ25MA05995500207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01769653Medicaid
NJ050066909OtherRAILROAD MEDICARE
NJ6670300Medicaid
NJG00189Medicare UPIN
NJ796938Medicare ID - Type UnspecifiedMEDICARE