Provider Demographics
NPI:1366923039
Name:STRONG, RENEE V
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:V
Last Name:STRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 SAINT JOHNS PL APT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3775
Mailing Address - Country:US
Mailing Address - Phone:718-764-7328
Mailing Address - Fax:718-771-2868
Practice Address - Street 1:1312 SAINT JOHNS PL APT 4A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3775
Practice Address - Country:US
Practice Address - Phone:718-764-7328
Practice Address - Fax:718-771-2868
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies