Healthcare Provider Details

I. General information

NPI: 1477535094
Provider Name (Legal Business Name): RONNA LEIGH TRENT R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WASHINGTON RD
WEST POINT NY
10996-1109
US

IV. Provider business mailing address

45 CLINTONWOOD DR
NEW WINDSOR NY
12553-7113
US

V. Phone/Fax

Practice location:
  • Phone: 845-938-6661
  • Fax:
Mailing address:
  • Phone: 845-938-6661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT06232
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: