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Individual
MR. THEODORE DAVID REZNOWSKI
Active
Individual
MR. THEODORE DAVID REZNOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-81941
NM
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN-81941
NM
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN-81941
NM
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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