Individual
JENNIFER MARIE REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
1305 YORK AVE, 12TH FLOOR, NEW YORK, NY 10021-5663
(646) 962-6200
Mailing address
1305 YORK AVE, 12TH FLOOR, NEW YORK, NY 10021-5663
(646) 962-6200
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017209
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017209
NEW YORK STATE LICENSE
NY
Enumeration date
11/13/2013
Last updated
09/15/2015
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