Provider Demographics
NPI:1891588141
Name:BORGES DOS SANTOS, RENATA (PI)
Entity type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:BORGES DOS SANTOS
Suffix:
Gender:F
Credentials:PI
Other - Prefix:
Other - First Name:RENATA
Other - Middle Name:
Other - Last Name:PSZCZOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PI
Mailing Address - Street 1:54 LITTLE SILVER PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1119
Mailing Address - Country:US
Mailing Address - Phone:929-373-8026
Mailing Address - Fax:
Practice Address - Street 1:54 LITTLE SILVER PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1119
Practice Address - Country:US
Practice Address - Phone:929-373-8026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter