Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 044363 | CT |
Y | 207RH0002X | Hospice and Palliative Medicine | 044363 | CT |
NPI | 1164750030 |
---|---|
Provider Name | Maria Renna |
First Address | Enfield, CT 06082-5423 |
Second Address | Enfield, CT 06082-5423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 02/11/2016 |