Basic Information
| Provider Information | |||||||||
| NPI: | 1922610765 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINCKLEY | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 STAFFORD ROAD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD CENTER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604568869 | ||||||||
| FaxNumber: | 8604501936 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 STAFFORD ROAD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD CENTER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604568869 | ||||||||
| FaxNumber: | 8604501936 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2020 | ||||||||
| LastUpdateDate: | 08/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 12747 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.