Provider Demographics
NPI:1871154625
Name:MOLCZAN, REBECCA (CRNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MOLCZAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3471 5TH AVE STE 810
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3206
Mailing Address - Country:US
Mailing Address - Phone:412-692-4917
Mailing Address - Fax:412-647-8398
Practice Address - Street 1:3471 5TH AVE STE 810
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3206
Practice Address - Country:US
Practice Address - Phone:412-692-4917
Practice Address - Fax:412-647-8398
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANPPA8522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology