Individual
ALISA RESNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3920 59TH ST APT 1, WOODSIDE, NY 11377-3436
(201) 965-8991
Mailing address
3920 59TH ST APT 1, WOODSIDE, NY 11377-3436
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002407
NY
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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