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General NPI Number Information
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NPI Number | 1902956212
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Entity Type | Individual
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Provider Name | DR. STEVEN RENNER
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1025 W ST GEORGE AVE
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City | LINDEN
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State | NJ
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Zip | 07036
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Country | US
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Telephone | 908-486-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 14 RIPPLING BROOK DR
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City | SHORT HILLS
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State | NJ
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Zip | 07078-1327
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Country | US
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Telephone | 973-376-0525
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00453201
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License Number State | NJ
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