Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 002756 | NY |
NPI | 1669529756 |
---|---|
Provider Name | Mr. Allan David Resman |
First Address | Williamsville, NY 14221-4648 |
Second Address | Williamsville, NY 14221-4648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010246701 | UNIVERA ID (01) | NY |
000607487001 | BC BS ID (01) | NY |
70694 | GHI ID (01) | NM |
9351386 | INDEPENDENT HEATLH ID (01) | NY |