Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 173338 | NY |
NPI | 1922064435 |
---|---|
Provider Name | Dr. David Resnick |
First Address | Poughkeepsie, NY 12601-5458 |
Second Address | Poughkeepsie, NY 12601-5458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 18/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0064483 | (05) | NJ |
01726521 | (05) | NY |
A400070039 | MEDICARE PTAN (01) | NY |
E76289 | (02) | NY |