MARIA REGINA RESIDENCE INC. NPI 1063419356

NPI Information

NPI: 1063419356
Provider Name: MARIA REGINA RESIDENCE, INC.
Classification: Clinic/Center - 261QA0600X
Specialization: Adult Day Care
Entity Type: Organization
CLIA Number: 33D2205302
Address: 1725 BRENTWOOD RD
BLDG 1
BRENTWOOD, NY
ZIP 11717
Phone: (631) 299-3000

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NPI Details

MARIA REGINA RESIDENCE, INC. is an adult day care clinic center in Brentwood, NY. MARIA REGINA RESIDENCE, INC. NPI is 1063419356. The provider is registered as an organization entity type.

The provider's business location address is:

1725 BRENTWOOD RD
BLDG 1
BRENTWOOD, NY
ZIP 11717-543
Phone: (631) 299-3000
Fax: (631) 299-3274

The provider's authorized official is Ilana Avinari .
The authorized official title is Cfo and has the following contact phone number (845) 447-1542.

The CLIA number assigned to this NPI record is 33D2205302 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/1/2005 and was last updated on 9/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care			Yes
2	314000000X	Skilled Nursing Facility		5154321N	NEW YORK	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02277085	MEDICAID	NEW YORK
2	02496748	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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