Provider Demographics
NPI:1467956029
Name:RENAISSANCE CDPAP 1, NY INC
Entity Type:Organization
Organization Name:RENAISSANCE CDPAP 1, NY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWITS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-582-0400
Mailing Address - Street 1:267 DOUGLASS ST FL 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2664
Mailing Address - Country:US
Mailing Address - Phone:718-649-3670
Mailing Address - Fax:908-378-3331
Practice Address - Street 1:267 DOUGLASS ST FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2664
Practice Address - Country:US
Practice Address - Phone:718-649-3670
Practice Address - Fax:908-378-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health