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NPI Code Detail

MEDICARE: MS. SHELLI G BREGMAN DO

MEDICARE: MS. SHELLI G BREGMAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZC0500XCytopathology PhysicianPENDINGPA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianPENDINGPA
3207ZP0102XAnatomic Pathology & Clinical Pathology Physician244704NY

General Provider Information

NPI Number : 1184666307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHELLI G BREGMAN DO
Provider Business Mailing Address
First Line : 4567 CROSSROADS PARK DRIVE
Second Line :
City : LIVERPOOL
State : NY
Zip : 13088-3589
Country : US
Telephone Number : 315-295-2100
Fax Number : 315-295-2125
Provider Business Practice Location Address
First Line : 1380 E MEDICAL CENTER DR
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84790-2123
Country : US
Telephone Number : 435-251-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 02/28/2023

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