Provider Demographics
NPI:1740407089
Name:RESANO, REZ PADPAD (PT)
Entity Type:Individual
Prefix:MR
First Name:REZ
Middle Name:PADPAD
Last Name:RESANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 RED SCHOOL LN APT T5
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2254
Mailing Address - Country:US
Mailing Address - Phone:908-859-2120
Mailing Address - Fax:
Practice Address - Street 1:390 RED SCHOOL LN
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2230
Practice Address - Country:US
Practice Address - Phone:908-859-0200
Practice Address - Fax:908-859-1961
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01239200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist