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General NPI Number Information
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NPI Number | 1134578735
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Entity Type | Individual
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Provider Name | COLIN RENAUD DC, MS, MSPAS, PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 02/25/2023
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Provider Practice Location Address
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Address Line | 3010 WESTCHESTER AVE STE 404
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City | PURCHASE
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State | NY
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Zip | 10577-2524
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Country | US
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Telephone | 914-730-7390
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Fax |
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Provider Business Mailing Address
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Address Line | 1137 WESTCHESTER AVE APT 2219
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City | WHITE PLAINS
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State | NY
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Zip | 10604-3524
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Country | US
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Telephone | 508-612-9618
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4660
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-09109
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 025726
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License Number State | NY
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