Healthcare Provider Details

I. General information

NPI: 1043295884
Provider Name (Legal Business Name): FRANK JOHN RINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 CHESTNUT RIDGE RD
WOODCLIFF LAKE NJ
07677-7663
US

IV. Provider business mailing address

595 CHESTNUT RIDGE RD
WOODCLIFF LAKE NJ
07677-7663
US

V. Phone/Fax

Practice location:
  • Phone: 201-930-8590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMA042804
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG 52497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: