Provider Demographics
NPI:1710600853
Name:TOUSSAINT, RENNES (DC)
Entity Type:Individual
Prefix:
First Name:RENNES
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RIDER CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-3062
Mailing Address - Country:US
Mailing Address - Phone:754-210-0544
Mailing Address - Fax:
Practice Address - Street 1:128 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2115
Practice Address - Country:US
Practice Address - Phone:973-344-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00791500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor