Healthcare Provider Details

I. General information

NPI: 1770434474
Provider Name (Legal Business Name): REGINA DITRANI CASAC-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2026
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 SHARROTTS RD
STATEN ISLAND NY
10309-1991
US

IV. Provider business mailing address

237 BREHAUT AVE
STATEN ISLAND NY
10307-1307
US

V. Phone/Fax

Practice location:
  • Phone: 255-352-6258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCASAC-T-41656
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: