Provider Demographics
NPI:1073731121
Name:.RESNICK, STEFFI BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEFFI
Middle Name:BETH
Last Name:.RESNICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E READ ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2403
Mailing Address - Country:US
Mailing Address - Phone:410-234-0007
Mailing Address - Fax:410-659-1943
Practice Address - Street 1:103 E READ ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2403
Practice Address - Country:US
Practice Address - Phone:410-234-0007
Practice Address - Fax:410-659-1943
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0176231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH412SOtherCAREFIRST BC BS MD
MDJ210OtherCAREFIRST BC BS NCA
MD4673985OtherAETNA
MD32448OtherMAMSI
MDH412SOtherCAREFIRST BC BS MD