Healthcare Provider Details

I. General information

NPI: 1952891699
Provider Name (Legal Business Name): RENEE HOPE REOPELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 23RD ST FL 5
NEW YORK NY
10011-2599
US

IV. Provider business mailing address

2816 8TH AVE APT 5PB
NEW YORK NY
10039-2189
US

V. Phone/Fax

Practice location:
  • Phone: 347-560-3725
  • Fax:
Mailing address:
  • Phone: 703-477-6198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number090120
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: