MEDICARE: MRS. SUSAN P. RESMAN LCSWR, ACSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R037342	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100078688001	OTHER	NY	APS ID
2	000524103001	OTHER	NY	BC BS WNY ID
3	11824	OTHER	NY	ENI ID

General Provider Information

NPI Number	:	1821145418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN P. RESMAN LCSWR, ACSW

Provider Business Mailing Address
First Line	:	4184 SENECA ST
Second Line	:	SUITE 208
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3051
Country	:	US
Telephone Number	:	716-675-4911
Fax Number	:	716-675-4978

Provider Business Practice Location Address
First Line	:	4184 SENECA ST
Second Line	:	SUITE 208
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3051
Country	:	US
Telephone Number	:	716-675-4911
Fax Number	:	716-675-4978

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/09/2007

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