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Organization

REGEN PHYSICIAN GROUP, PLLC

Active
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Organization

REGEN PHYSICIAN GROUP, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN VICTOR M.D. (PRESIDENT)
(212) 249-3050
Entity
Organization

Contact information

Practice address
460 PARK AVE FL 17, NEW YORK, NY 10022-1860
(212) 249-3050
Mailing address
460 PARK AVE FL 17, NEW YORK, NY 10022-1860

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CERT# 5957
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CERTIFICATE # 5957
AMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.
NY
Enumeration date
11/19/2015
Last updated
11/19/2015
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