Provider Demographics
NPI:1457880148
Name:CONRAD & RENZI, P.A.
Entity Type:Organization
Organization Name:CONRAD & RENZI, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:RENZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-560-3931
Mailing Address - Street 1:7402 YORK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7519
Mailing Address - Country:US
Mailing Address - Phone:410-560-3931
Mailing Address - Fax:410-560-0877
Practice Address - Street 1:7402 YORK RD STE 104
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7519
Practice Address - Country:US
Practice Address - Phone:410-560-3931
Practice Address - Fax:410-560-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty