Healthcare Provider Details

I. General information

NPI: 1861861189
Provider Name (Legal Business Name): RENALDO MILI MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 W 108TH ST
NEW YORK NY
10025-2956
US

IV. Provider business mailing address

248 W 108TH ST
NEW YORK NY
10025-2956
US

V. Phone/Fax

Practice location:
  • Phone: 212-663-3000
  • Fax: 212-663-3181
Mailing address:
  • Phone: 212-663-3000
  • Fax: 212-663-3181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: