MEDICARE: RENATO J BRIONES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	25MA04013800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194826099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENATO J BRIONES MD

Provider Business Mailing Address
First Line	:	12 SHEFFIELD LN
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-3318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 CREEK CROSSING BLVD
Second Line	:
City	:	HAINESPORT
State	:	NJ
Zip	:	08036-2766
Country	:	US
Telephone Number	:	609-267-1004
Fax Number	:	609-267-1044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	12/19/2023

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