Healthcare Provider Details

I. General information

NPI: 1548191968
Provider Name (Legal Business Name): PRISCA REGIS-ANDREW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 CENTRAL AVE
DUNKIRK NY
14048-3437
US

IV. Provider business mailing address

935 CENTRAL AVE
DUNKIRK NY
14048-3437
US

V. Phone/Fax

Practice location:
  • Phone: 929-488-0838
  • Fax:
Mailing address:
  • Phone: 929-488-0838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number758426
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: