Healthcare Provider Details

I. General information

NPI: 1023135290
Provider Name (Legal Business Name): MEREDITH MARY RENDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 01/27/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SOUTH ST. SUITE 206
RIDGEFIELD CT
06877-4125
US

IV. Provider business mailing address

55 DANBURY RD
WILTON CT
06897-4427
US

V. Phone/Fax

Practice location:
  • Phone: 203-431-3363
  • Fax: 203-762-1999
Mailing address:
  • Phone: 203-834-2436
  • Fax: 203-762-1999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49846
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number47168
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: