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General NPI Number Information
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NPI Number | 1255821799
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Entity Type | Organization
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Legal Business Name | RESNICK MEDICAL PRACTICE PC
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 229 COLERIDGE ST
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City | BROOKLYN
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State | NY
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Zip | 11235-4122
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Country | US
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Telephone | 917-501-0064
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Fax | 718-360-2279
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Provider Business Mailing Address
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Address Line | 229 COLERIDGE ST
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City | BROOKLYN
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State | NY
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Zip | 11235-4122
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Country | US
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Telephone | 917-501-0064
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Fax |
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Authorized Official
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Title or Position | MANANGER
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Name | LILY MARKMAN
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Credential | CREDENTION
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Telephone | 917-501-0064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 285233
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License Number State | NY
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