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Individual
JOSEPH RENZULLI
Active
Individual
JOSEPH RENZULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
60085
CT
208800000X
Urology Physician
Primary
MD11757
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659463230
GROUP NPI
RI
01
—
33583
BLUE SHIELD
RI
01
—
349005986
MEDICARE GROUP PTAN
RI
05
—
9004842
—
RI
Enumeration date
06/05/2006
Last updated
03/17/2018
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