Provider Demographics
NPI:1366641607
Name:YARON, RENAT (PT)
Entity type:Individual
Prefix:
First Name:RENAT
Middle Name:
Last Name:YARON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 3RD AVE
Mailing Address - Street 2:3G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5518
Mailing Address - Country:US
Mailing Address - Phone:646-271-7229
Mailing Address - Fax:212-228-6261
Practice Address - Street 1:20 W 20TH ST
Practice Address - Street 2:SUITE 405
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4213
Practice Address - Country:US
Practice Address - Phone:212-675-7585
Practice Address - Fax:212-228-6261
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist