Provider Demographics
NPI:1154692721
Name:LIM, REGINE MARIE (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:REGINE
Middle Name:MARIE
Last Name:LIM
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 AMITY ST
Mailing Address - Street 2:3RD FLOOR, ROOM H366
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6004
Mailing Address - Country:US
Mailing Address - Phone:718-780-1772
Mailing Address - Fax:718-780-1979
Practice Address - Street 1:97 AMITY ST
Practice Address - Street 2:3RD FLOOR, ROOM H366
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6004
Practice Address - Country:US
Practice Address - Phone:718-780-1772
Practice Address - Fax:718-780-1979
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS