Basic Information
Provider Information
NPI: 1073689220
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REGALADO
FirstName: ERIKA
MiddleName: CHARLOTTE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1650 SELWYN AVE
Address2: SUITE 6D
City: BRONX
State: NY
PostalCode: 104577626
CountryCode: US
TelephoneNumber: 7189601415
FaxNumber:  
Practice Location
Address1: 1650 GRAND CONCOURSE
Address2: ACN 3RD FLOOR
City: BRONX
State: NY
PostalCode: 104577606
CountryCode: US
TelephoneNumber: 7185185070
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/28/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X240888NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home