Organization
MARIA C RENNA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA C RENNA MD (OWNER)
(860) 634-3821
Entity
Organization
Contact information
Practice address
151 HAZARD AVE, STE 9, ENFIELD, CT 06082-4584
(860) 634-3821
Mailing address
151 HAZARD AVE., SUITE 9, ENFIELD, CT 06082-4588
(860) 634-3821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
044363
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
044363
CT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
044363
CT
Other
Enumeration date
06/03/2011
Last updated
04/24/2012
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