Provider Demographics
NPI:1750636536
Name:RESLINK, HOLLY S (DPT, ATC)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:S
Last Name:RESLINK
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:S
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10714 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14129-9746
Mailing Address - Country:US
Mailing Address - Phone:716-287-3734
Mailing Address - Fax:716-287-3740
Practice Address - Street 1:501 FAIR OAK ST
Practice Address - Street 2:
Practice Address - City:LITTLE VALLEY
Practice Address - State:NY
Practice Address - Zip Code:14755-1120
Practice Address - Country:US
Practice Address - Phone:716-938-6499
Practice Address - Fax:716-938-9165
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03004955Medicaid
NY03496917Medicaid
J400077811Medicare PIN