Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N004688 | NY |
NPI | 1053480954 |
---|---|
Provider Name | Dr. Adam Farley Resnikoff |
First Address | New York, NY 10016-6021 |
Second Address | New York, NY 10016-6021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0021318 | GHI (01) | NY |
P50912 | BLUE CROSS BLUE SHIELD (01) | NY |
U18037 | (02) | NY |