Provider Demographics
NPI:1013591031
Name:REGENNITTER, NICHOLAS STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:STEVEN
Last Name:REGENNITTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 FIELDGATE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3001
Mailing Address - Country:US
Mailing Address - Phone:650-898-2560
Mailing Address - Fax:
Practice Address - Street 1:3231 FIELDGATE CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3001
Practice Address - Country:US
Practice Address - Phone:650-898-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program