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Individual

MRS. REGINA D CANTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3326
(215) 707-8028

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR14993300
NJ
367500000X
Certified Registered Nurse Anesthetist
26NJ00419300
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN295931L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
92409
AANA
01
P01124448
RAILROAD MEDICARE
NJ
Enumeration date
12/18/2012
Last updated
04/13/2018
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