Individual
RENEE RIDZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
41 WORCESTER ST, #3, BOSTON, MA 02118-3906
(857) 753-4568
Mailing address
41 WORCESTER ST, #3, BOSTON, MA 02118-3906
(857) 753-4568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1092909
MA
207R00000X
Internal Medicine Physician
R2H71
MO
207RI0200X
Infectious Disease Physician
040984
GA
207RI0200X
Infectious Disease Physician
Primary
MD00042458
WA
207RI0200X
Infectious Disease Physician
MD7776
RI
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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