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Organization

MARIA REGINA RESIDENCE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ILANA AVINARI (CFO)
(845) 447-1542
Entity
Organization

Contact information

Practice address
1725 BRENTWOOD RD, BLDG 1, BRENTWOOD, NY 11717-5543
(631) 299-3000
(631) 299-3274
Mailing address
1725 BRENTWOOD RD, BLDG 1, BRENTWOOD, NY 11717-5543
(845) 447-1542
(845) 447-1544

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
314000000X
Skilled Nursing Facility
5154321N
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02277085
NY
05
02496748
NY
Enumeration date
07/01/2005
Last updated
09/17/2024
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