Provider Demographics
NPI:1255736948
Name:RENEE COMIZIO MD LLC
Entity type:Organization
Organization Name:RENEE COMIZIO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-775-9248
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:NEW VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07976-0122
Mailing Address - Country:US
Mailing Address - Phone:973-775-9248
Mailing Address - Fax:877-787-9098
Practice Address - Street 1:101 MADISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7305
Practice Address - Country:US
Practice Address - Phone:973-775-9248
Practice Address - Fax:877-787-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA087132002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty