Active NPI
Edlyn Regalado
- Physical Therapist
- West Orange, NJ
National Provider Identifier
1679120158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 456 Prospect Ave Ste C
West Orange, NJ 07052-4112 - Phone
- (973) 651-5000
- NPI assigned
- Aug 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
456 Prospect Ave Ste C
West Orange, NJ 07052-4112
Mailing address
1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1679120158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1377 MOTOR PKWY STE 307",
"city": "ISLANDIA",
"state": "NY",
"postal_code": "117495258",
"telephone_number": "631-580-5200",
"fax_number": "631-580-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 PROSPECT AVE STE C",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070524112",
"telephone_number": "973-651-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGALADO",
"first_name": "EDLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.