1053758383 NPI number — ALLISON B RESNICK D.C. LLC

Table of content: (NPI 1053758383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053758383 NPI number — ALLISON B RESNICK D.C. LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLISON B RESNICK D.C. LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053758383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 CLAPBOARD HILL RD STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUILFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06437-2282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-253-1051
Provider Business Mailing Address Fax Number:
860-391-8072

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 PEQUOT PARK RD
Provider Second Line Business Practice Location Address:
SUITE 201A
Provider Business Practice Location Address City Name:
WESTBROOK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06498-2856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-391-8068
Provider Business Practice Location Address Fax Number:
860-391-8072
Provider Enumeration Date:
05/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RESNICK
Authorized Official First Name:
ALLISON
Authorized Official Middle Name:
BETH
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
203-453-1051

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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