Provider Demographics
NPI:1740434869
Name:RESNIK, ALISSA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:
Last Name:RESNIK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:HIRSCHBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:136 WILLIAM ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-3819
Mailing Address - Country:US
Mailing Address - Phone:917-318-3708
Mailing Address - Fax:
Practice Address - Street 1:136 WILLIAM ST APT 4A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3819
Practice Address - Country:US
Practice Address - Phone:917-318-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist