Renel Alexis

Individual provider Active NPI Licensed Practical Nurse · Paterson, NJ

NPI 1023707361 · NPPES record last updated May 10, 2023

Key facts

NPI
1023707361
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
26NP07904800 (NJ)
Practice address
639 E 18TH St
Paterson, NJ 07501-2184
Phone
(973) 925-8885
NPI assigned
May 3, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
26NP07904800NJMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past
since May 7, 2023
Accepting new patients
Walgreen Co Past
since May 7, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 26NP07904800 NJ Yes

Addresses

Primary practice location

639 E 18TH St
Paterson, NJ 07501-2184

Mailing address

639 E 18TH St
Paterson, NJ 07501-2184

Other providers in Paterson, NJ

All providers in Paterson, NJ · Licensed Practical Nurse in New Jersey

Sources for this page

Verify at the official NPI Registry.