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General NPI Number Information
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NPI Number | 1447542477
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Entity Type | Organization
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Legal Business Name | REGINA CONSULTING LLC
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 6946 GRAND AVE
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City | MASPETH
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State | NY
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Zip | 11378-1827
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Country | US
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Telephone | 718-986-1491
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Fax | 718-606-9291
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Provider Business Mailing Address
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Address Line | 1 REGINA LN
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City | GLEN HEAD
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State | NY
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Zip | 11545-2717
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Country | US
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Telephone | 718-986-1491
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Fax | 718-606-9291
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ARMAND V ASADOURIAN
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Credential | M.D.
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Telephone | 718-986-1491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 163565
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License Number State | NY
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