DR GINA REGHETTI DO PC INC NPI 1841569902

NPI Information

NPI: 1841569902
Provider Name: DR GINA REGHETTI DO PC INC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 36D2026176

Address:
THE 110 BUILDING
110 EDWARD STREET, NW
WARREN, OH
ZIP 44483
Phone: (330) 847-3334
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DR GINA REGHETTI DO PC INC is a multi-specialty clinic center in Warren, OH. DR GINA REGHETTI DO PC INC NPI is 1841569902. The provider is registered as an organization entity type.

The provider's business location address is:

THE 110 BUILDING
110 EDWARD STREET, NW
WARREN, OH
ZIP 44483-118
Phone: (330) 847-3334
Fax: (330) 847-9301

The provider's authorized official is Dr. Gina Reghetti .
The authorized official title is Physician/surgeon and has the following contact phone number (330) 847-3334.

The CLIA number assigned to this NPI record is 36D2026176 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/19/2011 and was last updated on 8/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		34-006816-R	OHIO	No
2	261QH0100X	Clinic/Center	Health Service	34-006816-R	OHIO	No
3	261QM0850X	Clinic/Center	Adult Mental Health	34-006816-R	OHIO	No
4	261QM2500X	Clinic/Center	Medical Specialty	34-006816-R	OHIO	No
5	261QP2300X	Clinic/Center	Primary Care	34-006816-R	OHIO	No
6	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	34-006816-R	OHIO	No
7	261QM1300X	Clinic/Center	Multi-Specialty	34-006816-R	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H14494	MEDICARE UPIN	OHIO
2	RE 4018311	OTHER	OHIO	MEDICARE
3	064509	OTHER	OHIO	AOA # AMERICAN OSTEOPATHIC ASSOCIATION ID# 064509
4	000012833-00	OTHER	OHIO	OHIO BUREAU OF WORKERS' COMPENSATION CERTIFIED
5	36D2026176	OTHER	OHIO	CLIA WAIVER CERTIFICATE # 36D2026176 ACUTE OPIOID DETOX CLINIC, U.S.A.
6	H051310	OTHER	OHIO	MEDICARE ID AS OF 7-17-2013
7	XR5543485	OTHER	OHIO	SUBOXONE DEA # XR5543485
8	BR5543485	OTHER	OHIO	DEA LICENSE # BR5543485
9	8873	OTHER	ILLINOIS	AMERICAN OSTEOPATHIC BOARD OF FAMILY PHYSICIANS BOARD CERTIFICATION
10	XR5543485	OTHER	OHIO	WAIVER/OPIOID DETOX CLINIC, U.S.A. TX: SUBOXONE DEA # XR5543485
11	34-006816-R	OTHER	OHIO	STATE OF OHIO MEDICAL LICENSE # 34-006816-R
12	2174418	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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