Provider Demographics
NPI:1689279655
Name:SORBELLO, REGINA (RPH)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:SORBELLO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 WALMSLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-2348
Mailing Address - Country:US
Mailing Address - Phone:804-275-9235
Mailing Address - Fax:804-275-4642
Practice Address - Street 1:4715 WALMSLEY BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-2348
Practice Address - Country:US
Practice Address - Phone:804-275-9235
Practice Address - Fax:804-275-4642
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020091601835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy