Basic Information
Provider Information
NPI: 1184936809
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRIOCHE
FirstName: REGINE
MiddleName: COICOU
NamePrefix: MRS.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11 PARK PL STE 1200
Address2:  
City: NEW YORK
State: NY
PostalCode: 100072823
CountryCode: US
TelephoneNumber: 2122267666
FaxNumber: 9298889562
Practice Location
Address1: 15 WARREN ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100070029
CountryCode: US
TelephoneNumber: 2122267666
FaxNumber: 2122027988
Other Information
ProviderEnumerationDate: 07/10/2010
LastUpdateDate: 03/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X268858NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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