Healthcare Provider Details

I. General information

NPI: 1770888919
Provider Name (Legal Business Name): HENRY J. RYNGEL, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 HARRISON AVE
HARRISON NJ
07029-1348
US

IV. Provider business mailing address

28 HARRISON AVE
HARRISON NJ
07029-1348
US

V. Phone/Fax

Practice location:
  • Phone: 973-484-2929
  • Fax: 973-484-4280
Mailing address:
  • Phone: 973-484-2929
  • Fax: 973-484-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number25MA04193400
License Number StateNJ

VIII. Authorized Official

Name: HENRY JAMES RYNGEL
Title or Position: CHIEF EXECUTIVE
Credential: MD
Phone: 973-484-2929