Individual
MISS REGINE BLAISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FPMHNP
Contact information
Practice address
11835 QUEENS BLVD STE 1630, FOREST HILLS, NY 11375-7256
(925) 231-4325
Mailing address
PO BOX 1133, WEST BABYLON, NY 11704-0133
(631) 987-4632
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NJ15040200
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F404790
NY
Other
Enumeration date
02/27/2023
Last updated
04/24/2025
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