Provider Demographics
NPI:1700030038
Name:DOS REIS, RENATA CAMARGO LIMA (PT)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:CAMARGO LIMA
Last Name:DOS REIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SOUTH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4818
Mailing Address - Country:US
Mailing Address - Phone:845-483-7391
Mailing Address - Fax:845-483-1938
Practice Address - Street 1:205 SOUTH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4818
Practice Address - Country:US
Practice Address - Phone:845-483-7391
Practice Address - Fax:845-483-1938
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021115-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist