Healthcare Provider Details

I. General information

NPI: 1922064435
Provider Name (Legal Business Name): DR. DAVID RESNICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CROSFIELD AVE STE 406
WEST NYACK NY
10994-2212
US

IV. Provider business mailing address

2 CROSFIELD AVE STE 406
WEST NYACK NY
10994-2212
US

V. Phone/Fax

Practice location:
  • Phone: 845-353-9600
  • Fax: 973-248-9299
Mailing address:
  • Phone: 845-353-9600
  • Fax: 973-248-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number173338
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number173338
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number173338
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: