Individual
REBECCA R EZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2240 RIDGEWOOD RD, STE 100, WYOMISSING, PA 19610-1167
(610) 376-8691
(610) 376-8745
Mailing address
2240 RIDGEWOOD RD, STE 100, WYOMISSING, PA 19610-1167
(610) 376-8691
(610) 376-8745
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD046385L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06036
EPSDT
PA
05
—
1515130
—
PA
Enumeration date
06/13/2005
Last updated
09/10/2010
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