Provider Demographics
NPI:1609854322
Name:REGO, LOUIS PETER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:PETER
Last Name:REGO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 WATER ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4702
Mailing Address - Country:US
Mailing Address - Phone:732-442-5619
Mailing Address - Fax:
Practice Address - Street 1:161 WATER ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4702
Practice Address - Country:US
Practice Address - Phone:732-442-5619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R107447001835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20-050658OtherRPH LICENSE
TX43868OtherRPH LICENSE
PARP439839OtherRPH LICENSE
NJ28RI01744700OtherNJ LIC