Provider Demographics
NPI:1699750331
Name:RESNIK, REBECCA GABRIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:GABRIELLE
Last Name:RESNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 300
Mailing Address - Street 2:#210
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:1700 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5405
Practice Address - Country:US
Practice Address - Phone:303-418-7600
Practice Address - Fax:303-750-3137
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA223841207R00000X
CO45011207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ28600OtherBCBS MA
MA2101297Medicaid
MA468155OtherTUFTS HEALTH PLAN
CO19557027Medicaid
MA468155OtherTUFTS HEALTH PLAN
CO19557027Medicaid