Provider Demographics
NPI:1891971057
Name:SHPITSBERG, REGINA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:
Last Name:SHPITSBERG
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 1:80 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4811
Mailing Address - Country:US
Mailing Address - Phone:212-509-8890
Mailing Address - Fax:212-425-1948
Practice Address - Street 1:80 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4811
Practice Address - Country:US
Practice Address - Phone:212-509-8890
Practice Address - Fax:212-425-1948
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist