Provider Demographics
NPI:1922064435
Name:RESNICK, DAVID
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:RESNICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CROSFIELD AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2212
Mailing Address - Country:US
Mailing Address - Phone:845-353-9600
Mailing Address - Fax:973-248-9299
Practice Address - Street 1:2 CROSFIELD AVE STE 406
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2212
Practice Address - Country:US
Practice Address - Phone:845-353-9600
Practice Address - Fax:973-248-9299
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173338207K00000X, 2080P0201X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01726521Medicaid
NJ0064483Medicaid
NYA400070039OtherMEDICARE PTAN
NJ0064483Medicaid