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General NPI Number Information
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NPI Number | 1972649002
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Entity Type | Organization
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Legal Business Name | REGENCY MRI, P.C.
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 202 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-5405
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Country | US
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Telephone | 212-249-1111
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Fax | 212-249-1942
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Provider Business Mailing Address
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Address Line | 202 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-5405
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Country | US
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Telephone | 212-249-1111
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Fax | 212-249-1942
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID LELAND MILBAUER
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Credential | MD
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Telephone | 212-249-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 168702
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License Number State | NY
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