Provider Demographics
NPI:1649634817
Name:RESIGNATO, PAUL JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:RESIGNATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 EATON DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3858
Mailing Address - Country:US
Mailing Address - Phone:484-321-6977
Mailing Address - Fax:
Practice Address - Street 1:255 S 17TH ST STE 1608
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6216
Practice Address - Country:US
Practice Address - Phone:484-321-1697
Practice Address - Fax:844-868-8138
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA112496002084P0800X
PAMD4662642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1124631767OtherTHE ART OF WELLNESS, MD NPI