Provider Demographics
NPI:1487646493
Name:RESLER, ANDREW R (DPM)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:RESLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LITTLE BRITAIN RD
Mailing Address - Street 2:STE 101
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5100
Mailing Address - Country:US
Mailing Address - Phone:845-562-1271
Mailing Address - Fax:845-562-4417
Practice Address - Street 1:10 LITTLE BRITAIN RD
Practice Address - Street 2:STE 101
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5100
Practice Address - Country:US
Practice Address - Phone:845-562-1271
Practice Address - Fax:845-562-4417
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0-03113213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00584372Medicaid
NY00584372Medicaid
T50972Medicare UPIN