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NPI Code Detail

MEDICARE: REGINE MEDICAL PLLC

MEDICARE: REGINE MEDICAL PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician255151NY

General Provider Information

NPI Number : 1497294193
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGINE MEDICAL PLLC
Provider Business Mailing Address
First Line : 2462 FLATBUSH AVE
Second Line : #1
City : BROOKLYN
State : NY
Zip : 11234-5013
Country : US
Telephone Number : 718-252-0818
Fax Number : 631-366-0391
Provider Business Practice Location Address
First Line : 2462 FLATBUSH AVE
Second Line : #1
City : BROOKLYN
State : NY
Zip : 11234-5013
Country : US
Telephone Number : 718-252-0818
Fax Number : 631-366-0391
Authorized Official
Title or Position : OWNER
Name : DR. BRAULIO F COSME-THORMANN
Credential : MD
Telephone Number : 718-252-0818
Provider Enumeration Date : 02/15/2017
Last Update Date : 02/16/2017

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Directions to “REGINE MEDICAL PLLC ” Practice Location

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