Provider Demographics
NPI:1508452301
Name:ABRENILLA, RAINIER CAFE (APN)
Entity Type:Individual
Prefix:MR
First Name:RAINIER
Middle Name:CAFE
Last Name:ABRENILLA
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2808
Mailing Address - Country:US
Mailing Address - Phone:201-682-5276
Mailing Address - Fax:
Practice Address - Street 1:4 HIGHVIEW AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2808
Practice Address - Country:US
Practice Address - Phone:201-682-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310110363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health