MAVIS REN RD NPI 1295104172

NPI Information

  • NPI: 1295104172
  • Provider Name: MAVIS REN, RD
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Individual
  • Address: 9704 SUTPHIN BLVD
    JAMAICA, NY
    ZIP 11435
  • Phone: (718) 657-7088

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NPI Details

Mavis Ren, RD is a dietitian registered in Jamaica, NY. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. Mavis Ren, RD NPI is 1295104172. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9704 SUTPHIN BLVD
JAMAICA, NY
ZIP 11435-721
Phone: (718) 657-7088
Fax: (718) 657-7092

The enumeration date for this NPI number is 9/21/2015 and was last updated on 10/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, Registered008461-1MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100695941MEDICAIDNEW YORK
2331058MEDICARE OSCAR/CERTIFICATIONNEW YORK
3G1000004100MEDICARE OSCAR/CERTIFICATIONNEW YORK
4331944MEDICARE OSCAR/CERTIFICATIONMICHIGAN
5331978MEDICARE OSCAR/CERTIFICATIONMICHIGAN
6331043MEDICARE OSCAR/CERTIFICATIONMICHIGAN
7331009MEDICARE OSCAR/CERTIFICATIONMICHIGAN
8W6L111MEDICARE OSCAR/CERTIFICATIONMICHIGAN
9331945MEDICARE OSCAR/CERTIFICATIONMICHIGAN
10331943MEDICARE OSCAR/CERTIFICATIONMICHIGAN
11331946MEDICARE OSCAR/CERTIFICATIONMICHIGAN
12331947MEDICARE OSCAR/CERTIFICATIONMICHIGAN
13331952MEDICARE OSCAR/CERTIFICATIONMICHIGAN
14331954MEDICARE OSCAR/CERTIFICATIONMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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