Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 040441 | NY |
NPI | 1043412828 |
---|---|
Provider Name | Scott Resnick |
First Address | New York, NY 10021-8404 |
Second Address | New York, NY 10021-8404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |