Provider Demographics
NPI:1093895591
Name:REZNIK, SANDRA E (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:REZNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DANTE ST
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:718-904-2256
Practice Address - Street 1:WEILER - DEPT. OF PATHOLOGY
Practice Address - Street 2:1825 EASTCHESTER ROAD, 3RD FL.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-904-2861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191770207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology