Provider Demographics
NPI:1144274838
Name:RESNICK, MURRAY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:
Last Name:RESNICK
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 ELLENFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4541
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY APC-12
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-4380
Practice Address - Fax:401-444-4377
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77782207ZP0101X
RIMD10872207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7009590Medicaid
RIF81116Medicare UPIN
RI007009590Medicare ID - Type UnspecifiedGROUP# 229006185
RI007009589Medicare ID - Type UnspecifiedGROUP# 229006187