Organization
REGINALD M ROUSSEAU MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD M ROUSSEAU MD (OWNER)
(833) 547-7463
Entity
Organization
Contact information
Practice address
340 HOWELLS RD, BAY SHORE, NY 11706-5322
(833) 547-7463
(631) 247-5583
Mailing address
100 MOTOR PARKWAY, SUITE LL8, HAUPPAUGE, NY 11788
(833) 547-7463
(631) 248-5583
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/09/2023
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