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NPI Code Detail

MEDICARE: RENA KASSAK

MEDICARE: RENA KASSAK
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
1363LF0000XFamily Nurse Practitioner358920NY

General Provider Information

NPI Number : 1689518136
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENA KASSAK
Provider Business Mailing Address
First Line : 211 E 51ST ST
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 211 E 51ST ST
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6526
Country : US
Telephone Number : 212-398-1709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ RENA KASSAK ” Practice Location

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