Provider Demographics
NPI:1679311013
Name:DUKA, REGAN (MS ED/SPED)
Entity type:Individual
Prefix:
First Name:REGAN
Middle Name:
Last Name:DUKA
Suffix:
Gender:M
Credentials:MS ED/SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 WOODYCREST AVE APT 508
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-5512
Mailing Address - Country:US
Mailing Address - Phone:646-469-3191
Mailing Address - Fax:
Practice Address - Street 1:939 WOODYCREST AVE APT 508
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5512
Practice Address - Country:US
Practice Address - Phone:646-469-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1167070174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist