Provider Demographics
NPI:1073585907
Name:REGAN, THOMAS DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DANIEL
Last Name:REGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:835 SPRING HOUSE FARM LN
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2172
Mailing Address - Country:US
Mailing Address - Phone:619-977-6252
Mailing Address - Fax:
Practice Address - Street 1:822 PINE ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6187
Practice Address - Country:US
Practice Address - Phone:267-519-0154
Practice Address - Fax:267-519-0597
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236929207N00000X
NJ25MA08860400207ND0101X
PAMD441292207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology