Healthcare Provider Details

I. General information

NPI: 1922926088
Provider Name (Legal Business Name): MAREYA REGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 BOULEVARD STE 2
POMPTON PLAINS NJ
07444-1726
US

IV. Provider business mailing address

287 BOULEVARD STE 2
POMPTON PLAINS NJ
07444-1726
US

V. Phone/Fax

Practice location:
  • Phone: 845-393-4723
  • Fax:
Mailing address:
  • Phone: 845-393-4723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07464100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: