Provider Demographics
NPI:1134648322
Name:ULIS, REGINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:ULIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 N LEISURE WORLD BLVD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1367
Mailing Address - Country:US
Mailing Address - Phone:301-598-1583
Mailing Address - Fax:
Practice Address - Street 1:3305 N LEISURE WORLD BLVD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1367
Practice Address - Country:US
Practice Address - Phone:301-598-1583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD245081835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care