Diane M Renzulli, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X004316-1 Issued in NY

Practice address

6298 Woodhaven Blvd
Rego Park, NY 11374-3738

Phone

(718) 803-2300

Fax

(718) 565-2875

NPI assigned

Sep 25, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Modern RX Pharmacy Inc

  • Community/Retail Pharmacy
  • Rego Park, NY
  • NPI 1174102362
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1851541858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6298 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743738",
            "telephone_number": "718-803-2300",
            "fax_number": "718-565-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6298 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743738",
            "telephone_number": "718-803-2300",
            "fax_number": "718-565-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZULLI",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004316-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rego Specialty Inc
• Brianne Elizabeth Reilly
• Eileen Nora Rella, LMSW
• Remed Medical, P. C.
• Linda Renaud
• Aviva Reschke
• Jill Sarah Resnick, LMSW
• Sheldon Retkinski
• Jessica Christina Reyes
• Dmitry Reznikoff, D.O.

• Chiropractor in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.