Active NPI
Renie Eis, PNP
- Pediatric Nurse Practitioner
- New York, NY
National Provider Identifier
1891830709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 380052
- Practice address
- 4781 Broadway
New York, NY 10034-4915 - Phone
- (212) 304-6922
- Fax
- (212) 304-6924
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 380052 | NY | Primary |
Addresses
Primary practice location
4781 Broadway
New York, NY 10034-4915
Mailing address
22 Lancaster CT Apt B
Wayne, NJ 07470-7820
Phone (973) 839-6547
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354147200000",
"number": "1891830709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 LANCASTER CT APT B",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074707820",
"telephone_number": "973-839-6547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4781 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100344915",
"telephone_number": "212-304-6922",
"fax_number": "212-304-6924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EIS",
"first_name": "RENIE",
"name_prefix": "Ms.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2012-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "380052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.