Most Relevant Information
Provider Data
| NPI Number: | 1003680273 |
| Provider Name: | REGINA BURRIS |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 338412-01 |
Most Important Dates
| Enumeration Date: | 11/08/2023 |
| Last Updated: | 11/08/2023 |
Provider Practice Location
32 TUDOR LN
BAY SHORE
NY
117065530
Practice Location Phone/Fax
| Phone: | 5163224945 |
| Fax: |
Provider Mailing Location
32 TUDOR LN
BAY SHORE
NY
117065530
Provider Mailing Phone/Fax
| Phone: | 5163224945 |
| Fax: |