Provider Demographics
NPI:1184701476
Name:RESIG, LUCAS ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:ANTHONY
Last Name:RESIG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2772 ROUTE 16 NORTH
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760
Mailing Address - Country:US
Mailing Address - Phone:716-372-6274
Mailing Address - Fax:716-372-4610
Practice Address - Street 1:2772 ROUTE 16 NORTH
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760
Practice Address - Country:US
Practice Address - Phone:716-372-6274
Practice Address - Fax:716-372-4610
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0107811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
18541760OtherN AMERICAN ADMIN MERITAN
8812414OtherINDEPENDENT HEALTH
000527621001OtherBCBS OF WESTERN NEW YORK
838220OtherMANAGED PHYSICAL NETWORK
CL07815BOtherWORKERS COMP NEW YORK
664648OtherUNITED HEALTH CARE
838220OtherMANAGED PHYSICAL NETWORK
NYRA2485Medicare PIN