Provider Demographics
NPI:1902030539
Name:RESNICK, ALEX M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:M
Last Name:RESNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:M
Other - Last Name:WILLIAMS-RESNICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1000 10TH AVE
Mailing Address - Street 2:ROOSEVELT HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1147
Mailing Address - Country:US
Mailing Address - Phone:212-523-8312
Mailing Address - Fax:
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:ROOSEVELT HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-523-8312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262162208000000X
CAA107665208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics