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Individual

BRANDON J REGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10919 72ND RD, FOREST HILLS, NY 11375-7826
(718) 268-0418
Mailing address
224 SLATER BLVD, STATEN ISLAND, NY 10305-3241

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
02/27/2020
Last updated
08/25/2021
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