Healthcare Provider Details
I. General information
NPI: 1194723601
Provider Name (Legal Business Name): KLAUS PETER RENTROP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2005
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
131 W 35TH ST FLOOR 7
NEW YORK NY
10001-2111
US
IV. Provider business mailing address
131 W 35TH ST FLOOR 7
NEW YORK NY
10001-2111
US
V. Phone/Fax
- Phone: 212-475-8066
- Fax: 212-475-4175
- Phone: 212-475-8066
- Fax: 212-475-4175
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | 144465-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: