Healthcare Provider Details

I. General information

NPI: 1326973249
Provider Name (Legal Business Name): RENZO CONTRERAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 MORNINGSIDE RD
PARAMUS NJ
07652-1630
US

IV. Provider business mailing address

109 MORNINGSIDE RD
PARAMUS NJ
07652-1630
US

V. Phone/Fax

Practice location:
  • Phone: 201-394-2350
  • Fax:
Mailing address:
  • Phone: 201-394-2350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number13VH14095600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: