Provider Demographics
NPI:1114186400
Name:RESZKO, ANETTA ELZBIETA (MD)
Entity Type:Individual
Prefix:
First Name:ANETTA
Middle Name:ELZBIETA
Last Name:RESZKO
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 1:135 E 71ST ST # 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4383
Mailing Address - Country:US
Mailing Address - Phone:646-962-3376
Mailing Address - Fax:
Practice Address - Street 1:135 E 71ST ST # 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4383
Practice Address - Country:US
Practice Address - Phone:646-962-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245396207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology