Reginald Mark Regis

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

295491 Issued in NY

Practice address

9715 64TH Rd
Rego Park, NY 11374-2250

Phone

(718) 459-5592

Fax

(718) 459-6047

NPI assigned

May 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1811215239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 RUTLAND RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031849",
            "telephone_number": "347-758-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742250",
            "telephone_number": "718-459-5592",
            "fax_number": "718-459-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "REGINALD",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "295491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ena Rasic-Redzematovic
• Aishwarya Parth Raval
• Raymond Tam, MD, PC
• Ulugbek Razakov, PHARM D
• Refill RX Pharmacy Inc
• Registered Nursing Services P.C.
• Rego Med Supplies Corp
• Rego Medical Supply, Inc
• Rego Meds RX Corp
• Rego Park Adult Daycare Inc

• Licensed Practical Nurse in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.