Provider Demographics
NPI:1861598864
Name:NAL, RENITA R (RPH)
Entity type:Individual
Prefix:MS
First Name:RENITA
Middle Name:R
Last Name:NAL
Suffix:
Gender:F
Credentials:RPH
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Mailing Address - Street 1:605 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-5461
Mailing Address - Country:US
Mailing Address - Phone:516-775-5749
Mailing Address - Fax:718-896-3500
Practice Address - Street 1:9718 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3245
Practice Address - Country:US
Practice Address - Phone:718-896-1200
Practice Address - Fax:718-896-3500
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY049500-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist