Provider Demographics
NPI:1174871156
Name:KAYKATY, REGINA B (MS SP ED)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:B
Last Name:KAYKATY
Suffix:
Gender:F
Credentials:MS SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 TACOMA ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4222
Mailing Address - Country:US
Mailing Address - Phone:917-359-9340
Mailing Address - Fax:718-980-4944
Practice Address - Street 1:68 TACOMA ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4222
Practice Address - Country:US
Practice Address - Phone:917-359-9340
Practice Address - Fax:718-980-4944
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1074297174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist