Individual
DR. DEBRA A. RENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 HAGEN DR, SUITE 320, ROCHESTER, NY 14625-2658
(585) 922-0130
(585) 922-1042
Mailing address
30 HAGEN DR, SUITE 320, ROCHESTER, NY 14625-2658
(585) 922-0130
(585) 922-1042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101240877
VA
207Q00000X
Family Medicine Physician
190712
NY
207Q00000X
Family Medicine Physician
Primary
190712-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02603276
—
NY
Enumeration date
06/02/2006
Last updated
07/05/2023
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