Provider Demographics
NPI:1336679570
Name:RENDON, CHRISTIAN ELOY (RN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:ELOY
Last Name:RENDON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:CHRISTIAN
Other - Middle Name:ELOY
Other - Last Name:EKLEOV RENDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:50 HAVEN AVE # B6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2652
Mailing Address - Country:US
Mailing Address - Phone:516-384-8399
Mailing Address - Fax:
Practice Address - Street 1:170 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2612
Practice Address - Country:US
Practice Address - Phone:212-312-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY711021163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice