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Contact Information

RENAISSANCE PRIMARY CARE, LLC
11-15 SANDERSDALE ROAD
SOUTHBRIDGE, MA01550
 Phone: 774-420-2311
 Fax: 508-519-0763
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Mental Health

101YM0800X
 

Primary Care

261QP2300X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for RENAISSANCE PRIMARY CARE LLC · (Female)

NPI Number 1649729021
Status Active
Credentials
Entity Individual
Enumeration date 09/27/2016
Last updated 07/15/2025 - About 11 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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