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General NPI Number Information
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NPI Number | 1790641413
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Entity Type | Organization
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Legal Business Name | RENEWAL PSYCHIATRY LLC
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 84 BROAD ST OFC 7
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City | MILFORD
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State | CT
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Zip | 06460-3383
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Country | US
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Telephone | 860-809-3725
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Fax | 203-902-7419
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Provider Business Mailing Address
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Address Line | 84 BROAD ST OFC 7
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City | MILFORD
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State | CT
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Zip | 06460-3383
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Country | US
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Telephone | 860-809-3725
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Fax | 203-902-7419
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JOSEPH SALVATORE IMPELLIZERI
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Credential | APRN, PMHNP
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Telephone | 860-809-3725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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