Provider Demographics
NPI:1386728699
Name:HAUSLER, REGINA PERRY (PHD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:PERRY
Last Name:HAUSLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12512 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1713
Mailing Address - Country:US
Mailing Address - Phone:718-474-0373
Mailing Address - Fax:718-474-1636
Practice Address - Street 1:12512 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1713
Practice Address - Country:US
Practice Address - Phone:718-474-0373
Practice Address - Fax:718-474-1636
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical