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NPI 1902699671

NPI 1902699671 : ISABELLA RESNIKOFF PT, DPT : BELMONT, MA

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General NPI Number Information
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    NPI Number           |    1902699671
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    Entity Type          |    Individual 
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    Provider Name        |    ISABELLA RESNIKOFF PT, DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/27/2025
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    Last Update Date     |    10/17/2025
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Provider Practice Location Address
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    Address Line         |    284 TRAPELO RD 
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    City                 |    BELMONT
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    State                |    MA
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    Zip                  |    02478-1850
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    Country              |    US
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    Telephone            |    857-626-3284
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    Fax                  |    617-702-3242
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Provider Business Mailing Address
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    Address Line         |    2001 BUTTERFIELD RD STE 1600 
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    City                 |    DOWNERS GROVE
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    State                |    IL
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    Zip                  |    60515-1211
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    Country              |    US
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    Telephone            |    866-370-8206
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    Fax                  |    517-435-3670
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    055003
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PTL89017
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    License Number State |    MA
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