MEDICARE: DANIEL RENZONI RD, CDCES, TRAINER

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	133V00000X	Registered Dietitian	008437	NY
2	133V00000X	Registered Dietitian	86007861	NY

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	:	1427459973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RENZONI RD, CDCES, TRAINER

Provider Business Mailing Address
First Line	:	5 SPRING ROCK PL
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1715
Country	:	US
Telephone Number	:	845-709-2430
Fax Number	:	845-574-7755

Provider Business Practice Location Address
First Line	:	5 SPRING ROCK PL
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1715
Country	:	US
Telephone Number	:	845-709-2430
Fax Number	:

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

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	03/19/2026

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Directions to “ DANIEL RENZONI RD, CDCES, TRAINER” Practice Location

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