DR. TATYANA REZNIKOV (NPI# 1982819421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982819421 |
| Entity Type | Individual |
| Full Name | DR. TATYANA REZNIKOV |
| Other Name | TATYANA KHAZANOVA |
| Credential | MD |
| Practice Address |
116 Westminster Pike Suite 106 Reisterstown MD 21136-1027 |
| Practice Telephone | 4108331011 |
| Practice Fax Number | 4108331705 |
| Mailing Telephone | 4108331011 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-01-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
D0066080 | MD | Allopathic & Osteopathic Physicians |
| N | 204R00000X | Electrodiagnostic Medicine | D0066080 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 512314300 | 05 | |
| MD | MEDICARE PTAN | 130198 | 01 |
| Street Address |
116 WESTMINSTER PIKE SUITE 106 |
| City | REISTERSTOWN |
| State | MD |
| Zip Code | 21136-1027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215925128 | Jon D Koman | Orthopaedic Surgery | 116 Westminster Pike, Suite 100, Reisterstown, MD 21136-1027 | 2005-10-13 |
| 1497202444 | Koman Orthopedics and Sports Medicine | Durable Medical Equipment & Medical Supplies | 116 Westminster Pike, Suite 100, Reisterstown, MD 21136-1027 | 2016-09-07 |
| 1588020952 | David Alvarado | Physician Assistant | 116 Westminster Pike, Suite 100, Reisterstown, MD 21136-1027 | 2016-01-14 |
| 1174917736 | Pain Treatment Centers of Maryland, LLC | Physical Medicine & Rehabilitation | 116 Westminster Pike, Suite 106, Reisterstown, MD 21136-1027 | 2015-03-22 |
| 1679976815 | Koman Orthopaedics and Sports Medicine, LLC | Clinic/Center | 116 Westminster Pike, Suite 100, Reisterstown, MD 21136-1027 | 2014-10-02 |
| 1750703864 | Koman Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 116 Westminster Pike, Suite 100, Reisterstown, MD 21136-1027 | 2014-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791276 | Iyawamiwa Shittu | Counselor | 11 Chartley Drive, Reisterstown, MD 21136 | 2019-07-11 |
| 1508334517 | Amanda Britton | Speech-Language Pathologist | 12039 Reisterstown Rd., Reisterstown, MD 21136 | 2018-11-07 |
| 1366964272 | Marc Manko | Physician Assistant | 12608 Mt. Laurel Ct., Reisterstown, MD 21136 | 2017-07-12 |
| 1518325794 | Diana Jebaraj | Occupational Therapist | 15 Sunday Ct, Reisterstown, MD 21136 | 2016-02-03 |
| 1164816823 | Golda-amit Incorporated | Supports Brokerage | 11919 Tarragon Rd, Apt A, Reisterstown, MD 21136 | 2015-03-20 |
| 1073925210 | Irina Koyfman | Nurse Practitioner | 321 Chamborley Drive, Reisterstown, MD 21136 | 2014-05-22 |
| 1033462627 | Tracy Brenton | Counselor | 14450 Hanover Pike, Reisterstown, MD 21136 | 2012-10-19 |
| 1760738884 | Bonnie Lynne Haines | Massage Therapist | 141 Westminster Pike, Reisterstown, MD 21136 | 2012-07-26 |
| 1588921464 | Alexsandr Fishman | Dentist | 11710 Reisterstown Rd Ste 201, Reisterstown, MD 21136 | 2012-04-18 |
| 1992000954 | Darlene L. Reaka Israel | Nurse Practitioner | 23 Chartley Park Rd, Reisterstown, MD 21136 | 2011-01-21 |
| Find all providers in zip 21136 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174917736 | Pain Treatment Centers of Maryland, LLC | Physical Medicine & Rehabilitation | 116 Westminster Pike, Suite 106, Reisterstown, MD 21136-1027 | 2015-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285123869 | Eastside Medical Care | Physical Medicine & Rehabilitation | 732b E Main St, Salisbury, MD 21804-5037 | 2018-05-09 |
| 1225588676 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 7106 Ridge Rd Ste 100, Rosedale, MD 21237-3876 | 2016-10-10 |
| 1497203558 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 6615 Reisterstown Rd Ste 302, Baltimore, MD 21215-2689 | 2016-09-19 |
| 1558757914 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 3413 Olandwood Ct Ste 103, Olney, MD 20832-1489 | 2015-04-13 |
| 1033505391 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 6475 New Hampshire Ave Ste 620, Hyattsville, MD 20783-3280 | 2015-04-13 |
| 1477948842 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 1005 Northpoint Blvd Ste 722, Baltimore, MD 21224-3402 | 2015-04-02 |
| 1225459936 | Pain and Wellness Center of Maryland, LLC | Physical Medicine & Rehabilitation | 601 Post Office Rd Ste 2a, Waldorf, MD 20602 | 2013-12-23 |
| 1922429935 | Health Management and Rehabilitation LLC | Physical Medicine & Rehabilitation | 13907 Willow Tree Dr, Rockville, MD 20850-5434 | 2013-12-17 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| 1871868539 | Physical Medicine Associates Ltd | Physical Medicine & Rehabilitation | 174 Waterfront St, Suite 320, National Harbor, MD 20745 | 2012-03-14 |
| Find all providers with the same taxonomy | ||||
| City | REISTERSTOWN |
| Zip Code | 21136 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.