Provider Demographics
NPI:1023115607
Name:DRUZ, REGINA S (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:S
Last Name:DRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BARNYARD LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2809
Mailing Address - Country:US
Mailing Address - Phone:917-923-2795
Mailing Address - Fax:516-746-1114
Practice Address - Street 1:17201 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3475
Practice Address - Country:US
Practice Address - Phone:800-588-8628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204271207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02210084Medicaid
NY5R5981Medicare ID - Type Unspecified
NY02210084Medicaid