Provider Demographics
NPI:1114810447
Name:REGGIO, CHARLES JOSEPH
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOSEPH
Last Name:REGGIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4034
Mailing Address - Country:US
Mailing Address - Phone:908-290-7385
Mailing Address - Fax:
Practice Address - Street 1:170 BENNETT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-2901
Practice Address - Country:US
Practice Address - Phone:203-330-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical