Provider Demographics
NPI:1083722607
Name:RESSEGGER, ERIC ROBINSON (ATC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ROBINSON
Last Name:RESSEGGER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MAPLE AVE APT 5D
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4326
Mailing Address - Country:US
Mailing Address - Phone:516-398-9981
Mailing Address - Fax:
Practice Address - Street 1:1000 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11571-5002
Practice Address - Country:US
Practice Address - Phone:516-678-5000
Practice Address - Fax:516-256-2210
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000391-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer