Individual
DR. MARIO IVAN RENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 E 30TH ST, AP 8L, NEW YORK, NY 10016-6416
(212) 532-6840
(212) 532-6840
Mailing address
333 E 30TH ST, AP 8L, NEW YORK, NY 10016-6416
(212) 532-6840
(212) 532-6840
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
115369
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
115369
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01786447
—
NY
Enumeration date
03/25/2008
Last updated
03/25/2008
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