Provider Demographics
NPI:1972649002
Name:REGENCY MRI, P.C.
Entity Type:Organization
Organization Name:REGENCY MRI, P.C.
Other - Org Name:REGENCY MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LELAND
Authorized Official - Last Name:MILBAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-249-1111
Mailing Address - Street 1:202 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5405
Mailing Address - Country:US
Mailing Address - Phone:212-249-1111
Mailing Address - Fax:212-249-1942
Practice Address - Street 1:202 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5405
Practice Address - Country:US
Practice Address - Phone:212-249-1111
Practice Address - Fax:212-249-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168702261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology