Provider Demographics
NPI:1629337118
Name:PALU-REGAN, JOHN PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:PALU-REGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:PAUL
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:88 CLIFTON PL APT 819
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-7009
Mailing Address - Country:US
Mailing Address - Phone:713-859-9348
Mailing Address - Fax:
Practice Address - Street 1:104 PHEASANT RUN STE 123
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3413
Practice Address - Country:US
Practice Address - Phone:215-860-9600
Practice Address - Fax:215-633-3480
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019100208200000X
NJ25MB10128600208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery