Provider Demographics
NPI:1578712253
Name:MEYERS, RENEE JOY I
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:JOY
Last Name:MEYERS
Suffix:I
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:RENEE
Other - Middle Name:JOY
Other - Last Name:MEYERS
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8519 124 ST.
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415
Mailing Address - Country:US
Mailing Address - Phone:646-736-9415
Mailing Address - Fax:
Practice Address - Street 1:8519 124TH ST
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3308
Practice Address - Country:US
Practice Address - Phone:646-736-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171WH0202XOther Service ProvidersContractorHome Modifications