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NPI Code Detail

MEDICARE: MARK RENCHNER-KELLY

MEDICARE:   MARK  RENCHNER-KELLY
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
1390200000XStudent in an Organized Health Care Education/Training Program
21041C0700XClinical Social Worker096417NY

General Provider Information

NPI Number : 1427531854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK RENCHNER-KELLY
Provider Business Mailing Address
First Line : 18 MILLER RD
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-2220
Country : US
Telephone Number : 845-628-2300
Fax Number :
Provider Business Practice Location Address
First Line : 18 MILLER RD
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-2220
Country : US
Telephone Number : 845-628-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 07/16/2025

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