MEDICARE: DANIEL RENAHAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	035087	NC
2	261QP2000X	Physical Therapy Clinic/Center	10700	AZ

General Provider Information

NPI Number	:	1144612227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RENAHAN

Provider Business Mailing Address
First Line	:	52 CHAMBERS ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-1222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 CHAMBERS ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-1222
Country	:	US
Telephone Number	:	212-374-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2015
Last Update Date	:	01/25/2024

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Directions to “ DANIEL RENAHAN ” Practice Location

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