Provider Demographics
NPI:1932255999
Name:PERMAN, REGINA EILEEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:EILEEN
Last Name:PERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E NECK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1567
Mailing Address - Country:US
Mailing Address - Phone:631-424-7416
Mailing Address - Fax:631-424-7426
Practice Address - Street 1:129 E NECK RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-1567
Practice Address - Country:US
Practice Address - Phone:631-424-7416
Practice Address - Fax:631-424-7426
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004990-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist