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NPI Code Detail

MEDICARE: DR. RENEA M ASHKENAZI PSY.D.

MEDICARE: DR. RENEA M ASHKENAZI PSY.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
1103TC0700XClinical Psychologist019197-1NY

General Provider Information

NPI Number : 1790010577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENEA M ASHKENAZI PSY.D.
Provider Business Mailing Address
First Line : 2609 AVENUE L
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4632
Country : US
Telephone Number : 917-428-1412
Fax Number :
Provider Business Practice Location Address
First Line : 1268 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5241
Country : US
Telephone Number : 718-382-0045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2009
Last Update Date : 04/25/2023

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