Reznikoff, Glen A.

Reznikoff, Glen A. is an individual health care provider with primary practice located at 425 Post Road South Lobby, Fairfield CT 06824. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Reznikoff, Glen A. can be contacted via phone (203) 255-4545.

Contact Information

Primary practice address
425 Post Road South Lobby Fairfield CT 06824
Phone: (203) 255-4545
Fax: (203) 254-1191
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 035191 Connecticut
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 035191 Connecticut

Profile Details

NPI number 1457348088
LBN Legal business name Reznikoff, Glen A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Feb 24th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457348088 NPPES
Connecticut MEDICAID 001351915

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