Provider Demographics
NPI:1871529016
Name:YAVEL, REGINA (MD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:
Last Name:YAVEL
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 1:353 VETERANS MEMORIAL HIGHWAY
Mailing Address - Street 2:NEW YORK DERMATOLOGY & MOHS SURGERY GROUP, PLLC
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4233
Mailing Address - Country:US
Mailing Address - Phone:631-543-4888
Mailing Address - Fax:631-543-3549
Practice Address - Street 1:353 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4200
Practice Address - Country:US
Practice Address - Phone:631-543-4888
Practice Address - Fax:631-543-3549
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215146207N00000X, 207ND0101X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH78995Medicare UPIN