Provider Demographics
NPI:1679939680
Name:GARBOSE, REBECCA ADELENA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ADELENA
Last Name:GARBOSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ADELENA
Other - Last Name:MATYAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1133 21ST ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3324
Mailing Address - Country:US
Mailing Address - Phone:202-331-1740
Mailing Address - Fax:
Practice Address - Street 1:1133 21ST ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3324
Practice Address - Country:US
Practice Address - Phone:202-331-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0094756207V00000X
VA0101275274207V00000X
DCMD210002292207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology