Provider Demographics
NPI:1144361676
Name:RESNICK, ANDREW (MA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:RESNICK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 58TH ST
Mailing Address - Street 2:STE 411
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1166
Mailing Address - Country:US
Mailing Address - Phone:212-326-8475
Mailing Address - Fax:212-326-8585
Practice Address - Street 1:16 E 60TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1002
Practice Address - Country:US
Practice Address - Phone:212-326-8475
Practice Address - Fax:212-326-8585
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001643231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist