Provider Demographics
NPI:1114230141
Name:MOSHE, REGINA (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:
Last Name:MOSHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6336 99TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1941
Mailing Address - Country:US
Mailing Address - Phone:718-255-6615
Mailing Address - Fax:718-255-1394
Practice Address - Street 1:6336 99TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1941
Practice Address - Country:US
Practice Address - Phone:718-255-6615
Practice Address - Fax:718-255-1394
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY266873207R00000X
NJ25MA09078400207R00000X
PAMT194989207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine