Provider Demographics
NPI:1457311821
Name:O'REGAN, NEIL (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:O'REGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 VARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2134
Mailing Address - Country:US
Mailing Address - Phone:978-452-2121
Mailing Address - Fax:978-452-9371
Practice Address - Street 1:295 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2134
Practice Address - Country:US
Practice Address - Phone:978-452-2121
Practice Address - Fax:978-452-9371
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015364207V00000X
MA252535207V00000X
NH10965207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME03142006671601Medicaid
NH30200830Medicaid
NHMM833302Medicare PIN
H18538Medicare UPIN
MAMM833303Medicare PIN