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Export Provider Record NPI 1063419356
Maria Regina Residence, Inc.
Organization Subpart: NO
Active
NPI Number1063419356
NPI TypeNPI-2 Organization
SpecialtyClinic/Center, Adult Day Care
Provider Details
NPI1063419356
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2005-07-01
Last Updated2024-09-17
Authorized OfficialIlana Avinari
CFO
Phone: 8454471542
Mailing Address1725 Brentwood Rd, Bldg 1
Brentwood, NY 11717-5543
United States
Phone: (845) 447-1542 | Fax: (845) 447-1544
📍 View Map
Primary Practice Address1725 Brentwood Rd, Bldg 1
Brentwood, NY 11717-5543
United States
Phone: (631) 299-3000 | Fax: (631) 299-3274
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY02277085-
MEDICAIDNY02496748-
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes261QA0600X – Clinic/Center, Adult Day Care--
No314000000X – Skilled Nursing FacilityNY5154321N
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About NPI 1063419356

Maria Regina Residence, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1063419356. The primary specialty listed is Clinic/Center, Adult Day Care. The organization is located in Brentwood, NY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-07-01. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1063419356?

NPI 1063419356 belongs to Maria Regina Residence, Inc., a Clinic/Center, Adult Day Care in Brentwood, NY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1063419356 active?

The current status of NPI 1063419356 in the NPPES registry is Active. The record was last updated on 2024-09-17.

What specialty is NPI 1063419356?

NPI 1063419356 is classified under the taxonomy Clinic/Center, Adult Day Care. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1063419356?

You can verify NPI 1063419356 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1063419356?

The primary practice address on file for NPI 1063419356 is 1725 Brentwood Rd, Brentwood, NY 11717-5543. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1063419356 issued?

NPI 1063419356 was first issued (enumerated) on 2005-07-01. The NPPES record was last updated on 2024-09-17.

Practice Location Map

Maria Regina Residence, Inc. is located at 1725 Brentwood Rd, Brentwood, NY. Use the map below to find directions or verify the practice location.

📍 1725 Brentwood Rd, Brentwood, NY 11717-5543  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Maria Regina Residence, Inc.. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1063419356. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Skilled Nursing Facility5154321NNY
Data Verified from CMS NPPES Last synced: 2026-07-31 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162