Provider Demographics
NPI:1881126076
Name:RENIL, PRIYANKA (NP)
Entity type:Individual
Prefix:MS
First Name:PRIYANKA
Middle Name:
Last Name:RENIL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BEAUMONT CIR
Mailing Address - Street 2:APT 4
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1537
Mailing Address - Country:US
Mailing Address - Phone:914-413-5411
Mailing Address - Fax:
Practice Address - Street 1:51 BEAUMONT CIR
Practice Address - Street 2:APT 4
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1537
Practice Address - Country:US
Practice Address - Phone:914-413-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily