Healthcare Provider Details

I. General information

NPI: 1295813616
Provider Name (Legal Business Name): ROSE-MARIE FLORENCE REGIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 ROCKAWAY AVE
BROOKLYN NY
11212-5539
US

IV. Provider business mailing address

592 ROCKAWAY AVE
BROOKLYN NY
11212-5539
US

V. Phone/Fax

Practice location:
  • Phone: 718-345-5000
  • Fax:
Mailing address:
  • Phone: 718-345-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number154853
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: