Provider Demographics
NPI:1316947625
Name:RENZI, RONALD M (DPM)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:M
Last Name:RENZI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3620
Mailing Address - Country:US
Mailing Address - Phone:215-884-0140
Mailing Address - Fax:215-624-4763
Practice Address - Street 1:2002 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3620
Practice Address - Country:US
Practice Address - Phone:215-884-0140
Practice Address - Fax:215-624-4763
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002897-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29308Medicare UPIN
PARE 125194Medicare ID - Type Unspecified