| Renu Medi-spa | |
|
942 Route 376 Ste 17 Wappingers Falls NY 12590-6484 | |
| (845) 218-5007 | |
| Not Available |
| Full Name | Renu Medi-spa |
|---|---|
| Speciality | Internal Medicine |
| Location | 942 Route 376 Ste 17, Wappingers Falls, New York |
| Authorized Official Name and Position | Katelin Anne Buice (CREDENTIALING) |
| Authorized Official Contact | 8455279260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renu Medi-spa 942 Route 376 Ste 17 Wappingers Falls NY 12590-6484 Ph: () - | Renu Medi-spa 942 Route 376 Ste 17 Wappingers Falls NY 12590-6484 Ph: (845) 218-5007 |
| NPI Number | 1780331868 |
|---|---|
| Provider Enumeration Date | 03/08/2022 |
| Last Update Date | 08/19/2022 |
| Medicare PECOS PAC ID | 9638547367 |
|---|---|
| Medicare Enrollment ID | O20221130000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780331868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alice K Denicola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821605056 PECOS PAC ID: 6507254992 Enrollment ID: I20211104001740 |
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