MEDICARE: SHARON REGAN P. T.

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
1	225100000X	Physical Therapist	018385	NY

General Provider Information

NPI Number	:	1750373767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON REGAN P. T.

Provider Business Mailing Address
First Line	:	125 LATTIMORE RD
Second Line	:	SUITE 178
City	:	ROCHESTER
State	:	NY
Zip	:	14620-4159
Country	:	US
Telephone Number	:	585-442-9110
Fax Number	:	585-442-9049

Provider Business Practice Location Address
First Line	:	125 LATTIMORE RD
Second Line	:	SUITE 178
City	:	ROCHESTER
State	:	NY
Zip	:	14620-4159
Country	:	US
Telephone Number	:	585-442-9110
Fax Number	:	585-442-9049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/09/2007

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Directions to “ SHARON REGAN P. T.” Practice Location

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