Healthcare Provider Details
I. General information
NPI: 1831139500
Provider Name (Legal Business Name): INGE SOPHIA REGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/08/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64 PRINCETON HIGHTSTOWN RD STE 2
WEST WINDSOR NJ
08550-1103
US
IV. Provider business mailing address
90 MATAWAN RD STE 302
MATAWAN NJ
07747-2653
US
V. Phone/Fax
- Phone: 609-799-7009
- Fax: 609-799-7808
- Phone: 732-441-7177
- Fax: 732-441-7165
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 25MA06123600 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 25MA06123600 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: