Potter, Rebecca K

Potter, Rebecca K is an sole proprietor health care provider with primary practice located at 6700 Kirkville Rd Suite A, East Syracuse NY 13057-9305. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Potter, Rebecca K can be contacted via phone (315) 463-2013.

Contact Information

Primary practice address
6700 Kirkville Rd Suite A East Syracuse NY 13057-9305
Fax: (315) 463-2019
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 178456 New York

Profile Details

NPI number 1114081395
LBN Legal business name Potter, Rebecca K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2006
Last updated Mar 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114081395 NPPES
New York MEDICAID 01266724

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