Provider Demographics
NPI:1093049660
Name:MONACO, REGINA MAUREEN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:MAUREEN
Last Name:MONACO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 E PIEDMONT RD APT 2252
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-8620
Mailing Address - Country:US
Mailing Address - Phone:602-339-6542
Mailing Address - Fax:
Practice Address - Street 1:5102 E PIEDMONT RD APT 2252
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-8620
Practice Address - Country:US
Practice Address - Phone:602-339-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist