Healthcare Provider Details

I. General information

NPI: 1588594071
Provider Name (Legal Business Name): RENATA ATWOOD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2495 ROSENDALE RD
NISKAYUNA NY
12309-1399
US

IV. Provider business mailing address

2495 ROSENDALE RD
NISKAYUNA NY
12309-1399
US

V. Phone/Fax

Practice location:
  • Phone: 518-377-2233
  • Fax: 518-377-0655
Mailing address:
  • Phone: 518-377-2233
  • Fax: 518-377-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number707812
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: