Individual
REGINA PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6000
Mailing address
762 SEAPORT DR, ELIZABETH, NJ 07201-3385
(973) 444-9108
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ151182400
NJ
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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