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NPI 1093752255 · Internal Medicine Physician · Hasbrouck Heights, NJ
Provider details
- NPI number
- 1093752255
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Diane Renner, Adm(973) 304-4661
- License
- 39369 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
288 Boulevard
Hasbrouck Heights, NJ 07604-1315
Phone: (201) 288-6781
Fax: (201) 288-2734
Street-level locationGet directions
Mailing address
282 Lincoln Ave
Hawthorne, NJ 07506-1260
Registry dates
- Enumerated
- 2006-05-31
- Last updated
- 2017-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.