Organization Name: | THEODORE RENNA, MD PA |
NPI Number: | 1114022217 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDY ISLES (BILLING) |
Mailing Address: | 454 Old Street Rd Suite 206 Peterborough |
State: | NH US |
Postal Code: | 034581200 |
Phone Number: | 6039240002 |
Fax Number: | 6039240060 |
NPI Enumeration Date: | 09/13/2006 |
NPI Last Update Date: | 03/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |