Individual
JOSEPH MATTHEW RENDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
60 CHARLES AVE, MASSAPEQUA PARK, NY 11762-2822
(516) 672-5752
Mailing address
60 CHARLES AVE, MASSAPEQUA PARK, NY 11762-2822
(516) 672-5752
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
059963
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
03/14/2017
Last updated
10/14/2018
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