Provider Demographics
NPI:1194235432
Name:ORENSTEIN, RANDI LYNN (MSED)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:LYNN
Last Name:ORENSTEIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4022
Mailing Address - Country:US
Mailing Address - Phone:516-921-7171
Mailing Address - Fax:
Practice Address - Street 1:15 SHORE AVE
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-1401
Practice Address - Country:US
Practice Address - Phone:516-922-1049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-30
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNONEOtherNONE