Healthcare Provider Details

I. General information

NPI: 1861707523
Provider Name (Legal Business Name): RENEE MURRAY BACHMANN CDN, RN, CDE,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL
NEW YORK NY
10029-6500
US

V. Phone/Fax

Practice location:
  • Phone: 917-596-4842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number480765-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: