Provider Demographics
NPI:1831574912
Name:REGAN, SEAN A (PT)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:A
Last Name:REGAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RICHLANDTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18955
Mailing Address - Country:US
Mailing Address - Phone:267-371-4573
Mailing Address - Fax:
Practice Address - Street 1:108 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHLANDTOWN
Practice Address - State:PA
Practice Address - Zip Code:18955-1048
Practice Address - Country:US
Practice Address - Phone:267-371-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016361225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics