Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 263385 | NY |
Y | 111NI0900X | Internist | 263385 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 255919 | MA |
N | 207RI0011X | Interventional Cardiology | 255919 | MA |
NPI | 1003040676 |
---|---|
Provider Name | Charles D Resor |
First Address | Boston, MA 02115-6134 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 11/04/2018 |