Provider Demographics
NPI:1184004053
Name:SCHENKER, RENA MIRIAM (MS RD CDN)
Entity Type:Individual
Prefix:MRS
First Name:RENA
Middle Name:MIRIAM
Last Name:SCHENKER
Suffix:
Gender:F
Credentials:MS RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6631
Mailing Address - Country:US
Mailing Address - Phone:646-294-1321
Mailing Address - Fax:
Practice Address - Street 1:891 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6631
Practice Address - Country:US
Practice Address - Phone:646-294-1321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1004566133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered