Provider Demographics
NPI:1841851870
Name:REGIS, SAIDAH
Entity type:Individual
Prefix:MISS
First Name:SAIDAH
Middle Name:
Last Name:REGIS
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 1:388 MIDWOOD ST APT 3H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-5436
Mailing Address - Country:US
Mailing Address - Phone:347-238-4617
Mailing Address - Fax:
Practice Address - Street 1:6018 54TH PL UNIT 1
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-3305
Practice Address - Country:US
Practice Address - Phone:415-794-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health