Healthcare Provider Details

I. General information

NPI: 1457351645
Provider Name (Legal Business Name): MONIQUE MICHELINE REGARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 GRASSLANDS RD STE. 200
VALHALLA NY
10595-1503
US

IV. Provider business mailing address

503 GRASSLANDS RD STE 200
VALHALLA NY
10595-1503
US

V. Phone/Fax

Practice location:
  • Phone: 914-304-5254
  • Fax: 914-345-1755
Mailing address:
  • Phone: 914-304-5254
  • Fax: 914-345-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number225013
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: