Provider Demographics
NPI:1881203883
Name:RESNICK, CHANA
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:RESNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VOYAGER CT
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1647
Mailing Address - Country:US
Mailing Address - Phone:845-269-8649
Mailing Address - Fax:
Practice Address - Street 1:476 CHRISTIAN HERALD RD
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2230
Practice Address - Country:US
Practice Address - Phone:845-268-6861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-26
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist