Healthcare Provider Details

I. General information

NPI: 1538250055
Provider Name (Legal Business Name): ADINE F REGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 FARMINGTON AVENUE STE 220
FARMINGTON CT
06032
US

IV. Provider business mailing address

499 FARMINGTON AVENUE STE 220
FARMINGTON CT
06032
US

V. Phone/Fax

Practice location:
  • Phone: 860-678-7300
  • Fax: 860-677-2693
Mailing address:
  • Phone: 860-678-7300
  • Fax: 860-677-2693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number035127
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: