Provider Demographics
NPI:1598429391
Name:RENWICK, YANIQUE RAHJINA
Entity Type:Individual
Prefix:
First Name:YANIQUE
Middle Name:RAHJINA
Last Name:RENWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-2913
Mailing Address - Country:US
Mailing Address - Phone:212-695-4564
Mailing Address - Fax:
Practice Address - Street 1:307 W 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-2913
Practice Address - Country:US
Practice Address - Phone:212-695-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator