MEDICARE: RENZI MEDICAL,PC

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

General Provider Information

NPI Number	:	1710918149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENZI MEDICAL,PC

Provider Business Mailing Address
First Line	:	1324 W RITNER ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19148-3535
Country	:	US
Telephone Number	:	267-773-7311
Fax Number	:	267-773-7312

Provider Business Practice Location Address
First Line	:	1324 W RITNER ST
Second Line	:	SUITE A
City	:	PHILA
State	:	PA
Zip	:	19148-3535
Country	:	US
Telephone Number	:	267-773-7311
Fax Number	:	267-773-7312

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	TONI TORRIERO
Credential	:
Telephone Number	:	267-773-7311

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/15/2011

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