MEDICARE: RICHARD A RENZA DO PA

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316093636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD A RENZA DO PA

Provider Business Mailing Address
First Line	:	PO BOX 278
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-0278
Country	:	US
Telephone Number	:	609-523-1331
Fax Number	:	609-522-1516

Provider Business Practice Location Address
First Line	:	6410 NEW JERSEY AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-1216
Country	:	US
Telephone Number	:	609-523-1331
Fax Number	:	609-522-1516

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD ALLEN RENZA
Credential	:	DO
Telephone Number	:	609-523-1331

Provider Enumeration Date	:	01/27/2007
Last Update Date	:	08/22/2020

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