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General NPI Number Information
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NPI Number | 1255736948
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Entity Type | Organization
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Legal Business Name | RENEE COMIZIO MD LLC
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 101 MADISON AVE STE 200
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7305
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Country | US
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Telephone | 973-775-9248
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Fax | 877-787-9098
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Provider Business Mailing Address
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Address Line | PO BOX 122
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City | NEW VERNON
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State | NJ
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Zip | 07976-0122
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Country | US
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Telephone | 973-775-9248
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Fax | 877-787-9098
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Authorized Official
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Title or Position | OFFICE ADMIN
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Name | KRISTEN AWN
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Credential |
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Telephone | 973-775-9248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 25MA08713200
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License Number State | NJ
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