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Individual

REGINA BACCHUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10 NATHAN D PERLMAN PLACE, NEW YORK, NY 10003
(212) 844-1871
Mailing address
56 BROOKSIDE RD, CLARKSBURG, NJ 08510-1235
(732) 308-3499

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
433362
NY

Other

Enumeration date
04/01/2016
Last updated
04/01/2016
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