Active NPI
Peter Reznik
- Adult Mental Health Clinic/Center
- New York, NY
National Provider Identifier
1003270224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- License
- 070359-1
- Practice address
- 1641 3Rd Ave Ste 201
New York, NY 10128-3623 - Phone
- (973) 572-9972
- NPI assigned
- Apr 13, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | 070359-1 | NY | Primary |
Addresses
Primary practice location
1641 3Rd Ave Ste 201
New York, NY 10128-3623
Mailing address
11050 71St Rd Apt 8E
Forest Hills, NY 11375-4970
Phone (973) 572-9972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070359-1 | NY | MD | Adult Mental Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1003270224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11050 71ST RD APT 8E",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754970",
"telephone_number": "973-572-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1641 3RD AVE STE 201",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101283623",
"telephone_number": "973-572-9972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZNIK",
"first_name": "PETER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-13",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": "NY",
"license": "070359-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.