| Doctor Name: | REGINA G MUIR |
| NPI Number: | 1346440013 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | F381158-1 |
| Business Practice Address: | 492 Montauk Hwy East Moriches, NY - 119401347 |
| Business Phone Number: | 6316382900 |
| Business Fax Number: | 6318788083 |
| Mailing Address: | Po Box 1559, Suite 104 STONY BROOK |
| State: | NY |
| Postal Code: | 117900989 |
| Phone Number: | 6316382900 |
| Fax Number: | 6318788083 |
| NPI Enumeration Date: | 07/20/2007 |
| NPI Last Update Date: | 12/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | F381158-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |