Provider Demographics
NPI:1033969928
Name:VARACCHI, REGINA CATHERINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:CATHERINE
Last Name:VARACCHI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:REGINA
Other - Middle Name:CATHERINE
Other - Last Name:VARACCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:318 WYNN LN APT 2
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1698
Mailing Address - Country:US
Mailing Address - Phone:631-402-4825
Mailing Address - Fax:
Practice Address - Street 1:318 WYNN LN APT 2
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1698
Practice Address - Country:US
Practice Address - Phone:631-402-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY723773163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy