Provider Demographics
NPI:1386636058
Name:RESNICK, MICHAEL I SR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:I
Last Name:RESNICK
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:845-356-2900
Mailing Address - Fax:845-356-7797
Practice Address - Street 1:327 ROUTE 59
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952
Practice Address - Country:US
Practice Address - Phone:845-356-2900
Practice Address - Fax:845-356-7797
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086369207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0014638OtherAETNA HMO#
NY570F13OtherEMPIRE BCBS (AIRMONT)
NY391733OtherMVP (AIRMONT/STONY POINT)
NY570F11OtherEMPIRE BCBS (STONY POINT)
NY00133739Medicaid
NY570F12OtherEMPIRE BCBS (MONROE)
NY0039141OtherGHI PPO
NY0D0562OtherHEALTHNET
NY391734OtherMVP (MONROE)
NYRS358OtherOXFORD
NY4413534OtherAETNA PPO#
B15113Medicare UPIN
NY0014638OtherAETNA HMO#