Individual
GLEN A. REZNIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 POST ROAD, SOUTH LOBBY, FAIRFIELD, CT 06824
(203) 255-4545
(203) 254-1191
Mailing address
425 POST ROAD, SOUTH LOBBY, FAIRFIELD, CT 06824
(203) 255-4545
(203) 254-1191
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
035191
CT
207RH0003X
Hematology & Oncology Physician
Primary
035191
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001351915
—
CT
Enumeration date
09/29/2005
Last updated
02/24/2014
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