MEDICARE: RUCHELE REGENCIA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	027579	NY

General Provider Information

NPI Number	:	1558491563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUCHELE REGENCIA PT

Provider Business Mailing Address
First Line	:	8610 GRAND AVE APT 7N
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4383
Country	:	US
Telephone Number	:	646-852-5645
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 W 33RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1404
Country	:	US
Telephone Number	:	646-852-5645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	02/07/2025

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Directions to “ RUCHELE REGENCIA PT” Practice Location

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