Provider Demographics
NPI:1407105810
Name:CARDACI, REGINA (RN, CNM, NP)
Entity Type:Individual
Prefix:PROF
First Name:REGINA
Middle Name:
Last Name:CARDACI
Suffix:
Gender:F
Credentials:RN, CNM, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162-41 POWELLS COVE BLVD
Mailing Address - Street 2:4L
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1543
Mailing Address - Country:US
Mailing Address - Phone:718-640-5674
Mailing Address - Fax:
Practice Address - Street 1:162-41 POWELLS COVE BLVD
Practice Address - Street 2:4L
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1543
Practice Address - Country:US
Practice Address - Phone:718-640-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY361038-1163W00000X
NYF360461-1363LW0102X
NYF000449-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife