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General NPI Number Information
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NPI Number | 1245082908
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Entity Type | Individual
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Provider Name | RENEE RENOUF PA(ASCP)CM
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Gender | Female
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 100 PARK ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-4447
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Country | US
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Telephone | 860-818-1887
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Fax |
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Provider Business Mailing Address
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Address Line | 46 VIA DA VINCI
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City | CLIFTON PARK
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State | NY
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Zip | 12065-2907
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Country | US
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Telephone |
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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 | 246R00000X
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Taxonomy Name | Pathology Technician
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License Number | 000275-01
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License Number State | NY
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