Provider Demographics
NPI:1528584968
Name:REGITS, LYSA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYSA
Middle Name:
Last Name:REGITS
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 1:7172 COLUMBIA GATEWAY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2993
Mailing Address - Country:US
Mailing Address - Phone:888-662-6779
Mailing Address - Fax:
Practice Address - Street 1:7172 COLUMBIA GATEWAY DR STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2993
Practice Address - Country:US
Practice Address - Phone:888-662-6779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist