Provider Demographics
NPI:1689608960
Name:REGENCY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:REGENCY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEROTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-796-8185
Mailing Address - Street 1:640 FULTON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3460
Mailing Address - Country:US
Mailing Address - Phone:516-796-8185
Mailing Address - Fax:516-396-4572
Practice Address - Street 1:640 FULTON ST STE 1
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3460
Practice Address - Country:US
Practice Address - Phone:516-796-8185
Practice Address - Fax:516-396-4572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02917820Medicaid
NY02917820Medicaid