MEDICARE: DR. DAVID RENSHON M.D.

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	2084P0800X	Psychiatry Physician	285690	NY

General Provider Information

NPI Number	:	1518352087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RENSHON M.D.

Provider Business Mailing Address
First Line	:	151 W 28TH ST APT 3E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-6122
Country	:	US
Telephone Number	:	646-637-3000
Fax Number	:	844-354-8839

Provider Business Practice Location Address
First Line	:	151 W 28TH ST APT 3E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-6122
Country	:	US
Telephone Number	:	646-637-3000
Fax Number	:	844-354-8839

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

Provider Enumeration Date	:	04/01/2015
Last Update Date	:	10/28/2021

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