Provider Demographics
NPI:1669794103
Name:REGIS, YOUSELINE
Entity type:Individual
Prefix:
First Name:YOUSELINE
Middle Name:
Last Name:REGIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19803 DUNTON AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1409
Mailing Address - Country:US
Mailing Address - Phone:646-515-6441
Mailing Address - Fax:
Practice Address - Street 1:19803 DUNTON AVE
Practice Address - Street 2:APT 2
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1409
Practice Address - Country:US
Practice Address - Phone:646-515-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299334163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse