Provider Demographics
NPI:1073050381
Name:STRIANO, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:STRIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:192 TILDEN ST
Mailing Address - Street 2:
Mailing Address - City:PORT EWEN
Mailing Address - State:NY
Mailing Address - Zip Code:12466-7757
Mailing Address - Country:US
Mailing Address - Phone:845-662-7070
Mailing Address - Fax:
Practice Address - Street 1:192 TILDEN ST
Practice Address - Street 2:
Practice Address - City:PORT EWEN
Practice Address - State:NY
Practice Address - Zip Code:12466-7757
Practice Address - Country:US
Practice Address - Phone:845-662-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273086-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse