Provider Demographics
NPI:1801643440
Name:REGA, ERIN ELIZABETH
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:REGA
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 1:51 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8835
Mailing Address - Country:US
Mailing Address - Phone:631-456-2012
Mailing Address - Fax:
Practice Address - Street 1:51 RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8835
Practice Address - Country:US
Practice Address - Phone:631-456-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0942501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical