Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | A1791961 | NY |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A1791961 | NY |
NPI | 1336135193 |
---|---|
Provider Name | Dr. Regina M. Asaro |
First Address | Middle Village, NY 11379-1904 |
Second Address | Middle Village, NY 11379-1904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 10/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F35218 | (02) | NY |