Reagen Medical, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

138656-1 Issued in NY

Legal business name

REAGEN MEDICAL, PC

Practice address

460 Park Avenue
17TH Floor
New York, NY 10022

Phone

(212) 249-3050

Fax

(212) 452-2354

NPI assigned

Feb 24, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Steven Victor, M.D.

Title

MD/Ceo

Phone

(212) 249-3050

Specialties & licenses 1

Addresses

Tax ID family

Reagen Medical PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Regen Medical, PC

  • Specialist
  • New York, NY
  • NPI 1508109596
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1679965990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 PARK AVENUE",
            "address_2": "17TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-249-3050",
            "fax_number": "212-452-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 PARK AVENUE",
            "address_2": "17TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-249-3050",
            "fax_number": "212-452-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAGEN MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "VICTOR",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "212-249-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "138656-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in New York, NY
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.