Basic Information
| Provider Information | |||||||||
| NPI: | 1275539785 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REZNIK | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 WASHINGTON AVE FL 1A | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038656784 | ||||||||
| FaxNumber: | 2038656788 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 WASHINGTON AVE FL 1A | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038656784 | ||||||||
| FaxNumber: | 2038656788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2005 | ||||||||
| LastUpdateDate: | 06/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 029781 | CT | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | 029781 | CT | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.