Healthcare Provider Details

I. General information

NPI: 1609852987
Provider Name (Legal Business Name): JAMES B REGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 609-833-9833
  • Fax: 609-407-2364
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101040080
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number25MA04135700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: