Healthcare Provider Details

I. General information

NPI: 1124197066
Provider Name (Legal Business Name): REGINA GINZBURG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 UTOPIA PKWY SAINT ALBERTS HALL 114
JAMAICA NY
11439-0001
US

IV. Provider business mailing address

11215 72ND RD 403
FOREST HILLS NY
11375-4663
US

V. Phone/Fax

Practice location:
  • Phone: 718-990-2019
  • Fax:
Mailing address:
  • Phone: 718-990-2019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number047252
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: