Healthcare Provider Details

I. General information

NPI: 1871403220
Provider Name (Legal Business Name): REGINA KANGELA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 FLORAL AVE APT 12
BINGHAMTON NY
13905-3244
US

IV. Provider business mailing address

58 FLORAL AVE APT 12
BINGHAMTON NY
13905-3244
US

V. Phone/Fax

Practice location:
  • Phone: 607-773-4597
  • Fax:
Mailing address:
  • Phone: 607-773-4597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberN29818
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: