Provider Demographics
NPI:1518045467
Name:COYNE, REGINA (NP)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:
Last Name:COYNE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1400 PELHAM PKWY S
Mailing Address - Street 2:JAACOBI MEDICAL CENTER BUILDING 1 4W
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-918-6041
Mailing Address - Fax:718-918-7701
Practice Address - Street 1:1400 PELHAM PARKWAY S
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-6041
Practice Address - Fax:718-918-7701
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF3004521363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S51212Medicare UPIN