Provider Demographics
NPI:1790356434
Name:MACHARIA, REGINA
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:MACHARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 LITTLETON RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3530
Mailing Address - Country:US
Mailing Address - Phone:978-581-1735
Mailing Address - Fax:978-506-2313
Practice Address - Street 1:234 LITTLETON RD STE 1B
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3530
Practice Address - Country:US
Practice Address - Phone:978-581-1735
Practice Address - Fax:978-506-2313
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-04
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265827363LP0808X
MARN265827163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health