Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | CT000515 | CT |
Y | 222Z00000X | Podiatrist | CT000515 | CT |
NPI | 1063416683 |
---|---|
Provider Name | Dr. Lonnie Neil Resnick IX |
First Address | Norwalk, CT 06851-4902 |
Second Address | Norwalk, CT 06851-4902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 14/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004095205 | (05) | CT |
030000515CT04 | ANTHEM BC-BS (01) | CT |
OV0227 | HEALTHNET (01) | CT |
T90689 | (02) | CT |
ZS274 | OXFORD (01) | CT |