Individual
MADELINE REGANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
117 S. 11TH STREET, 204 PAVILION, PHILADELPHIA, PA 19107-4949
(215) 503-3876
Mailing address
117 S. 11TH STREET, 204 PAVILION, PHILADELPHIA, PA 19107-4949
(215) 503-3876
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
OT019425
PA
Other
Enumeration date
06/26/2019
Last updated
08/06/2019
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