Active NPI
Raisa Vladimir Reznik, MD,DC
- Pharmacist
- Clinton, MD
National Provider Identifier
1730673237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14292
- Practice address
- 6300 Coventry Way
Clinton, MD 20735-2256 - Phone
- (301) 868-0157
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14292 | MD | Primary |
Addresses
Primary practice location
6300 Coventry Way
Clinton, MD 20735-2256
Mailing address
3000 Birchtree LN
Silver Spring, MD 20906-3034
Phone (301) 233-5654
Other practice location 1
2950 Donnell Dr
Forestville, MD 20747-3256
Phone (240) 492-0189
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14292 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529280000000",
"number": "1730673237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 BIRCHTREE LN",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209063034",
"telephone_number": "301-233-5654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 COVENTRY WAY",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352256",
"telephone_number": "301-868-0157"
}
],
"practiceLocations": [
{
"address_1": "2950 Donnell Dr",
"address_purpose": "LOCATION",
"city": "Forestville",
"state": "MD",
"postal_code": "207473256",
"country_code": "US",
"telephone_number": "240-492-0189",
"fax_number": "240-492-0192",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REZNIK",
"first_name": "RAISA",
"middle_name": "VLADIMIR",
"name_prefix": "Mrs.",
"credential": "MD,DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-18",
"last_updated": "2018-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "14292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.