Look up the most recent NPI and PECOS records

Antonin Jiri Reznicek

Internal Medicine

Allopathic & Osteopathic Physicians

14015 Sanford Ave, Flushing, NY 11355-2686

PECOS Enrollment

This provider is enrolled in PECOS as ANTONIN REZNICEK.

Based on the most recent information from CMS, provider Antonin Jiri Reznicek is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1497195176
Provider Type
Individual
Full Name
Reznicek, Antonin Jiri
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/26/2013
Last Updated
3/2/2022

Contact Information

Practice Location

14015 Sanford Ave, Flushing, NY 11355-2686

(718) 826-4000

(718) 826-4075

Mailing Location

55 Water Street, 2nd Floor Cred Dept, New York, NY 10041-0004

(646) 680-2888

(516) 542-5556

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 285603 New York
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 285603 New York

Antonin Jiri Reznicek

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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