Individual
NORMAN PAUL REZNICOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7362 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3151
(763) 571-1800
(763) 571-1880
Mailing address
7362 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3151
(763) 571-1800
(763) 571-1880
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1582
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021823500
—
MN
01
—
14490RE
BLUE CROSS
MN
Enumeration date
08/09/2005
Last updated
12/16/2009
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