Individual
REGINA EMBRADOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1843 W MAIN ST, TROY, OH 45373-2303
(937) 208-4020
(937) 208-4126
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006046RX
OH
363A00000X
Physician Assistant
C0006446
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1141856
NCCPA
—
01
—
C0006446
MARYLAND BOARD OF PHYSICIANS
MD
Enumeration date
06/20/2017
Last updated
10/07/2019
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