Individual
MICHAEL T REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT-B
Contact information
Practice address
478 ELWOOD RD, ELWOOD, NY 11731-4828
(978) 382-2859
Mailing address
6109 171ST ST FL 2, FRESH MEADOWS, NY 11365-2023
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003189
NY
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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