| Organization Name: | M. RENDA, RD, CDN |
| NPI Number: | 1114308459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARION RENDA (REGISTERED DIETITIAN, CDN) |
| Mailing Address: | 2415 Jerusalem Ave Suite 106 North Bellmore |
| State: | NY US |
| Postal Code: | 117101870 |
| Phone Number: | 5166725927 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2015 |
| NPI Last Update Date: | 06/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 005185-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |