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NPI 1386636058

NPI 1386636058 : MICHAEL I RESNICK SR. MD : AIRMONT, NY

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General NPI Number Information
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    NPI Number           |    1386636058
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL I RESNICK SR. MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/18/2005
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    Last Update Date     |    02/05/2008
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Provider Practice Location Address
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    Address Line         |    327 ROUTE 59 
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    City                 |    AIRMONT
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    State                |    NY
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    Zip                  |    10952
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    Country              |    US
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    Telephone            |    845-356-2900
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    Fax                  |    845-356-7797
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Provider Business Mailing Address
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    Address Line         |    327 ROUTE 59 
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    City                 |    AIRMONT
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    State                |    NY
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    Zip                  |    10952
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    Country              |    US
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    Telephone            |    845-356-2900
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    Fax                  |    845-356-7797
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery Physician
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    License Number       |    086369
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    License Number State |    NY
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