MEDICARE: ELLIOT L PLOTKIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	MD001660	NJ

General Provider Information

NPI Number	:	1063698496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLIOT L PLOTKIN DPM

Provider Business Mailing Address
First Line	:	185 BRIDGE PLZ N
Second Line	:	SUITE 4
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5907
Country	:	US
Telephone Number	:	201-363-9844
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 BRIDGE PLZ N
Second Line	:	SUITE 4
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5907
Country	:	US
Telephone Number	:	201-363-9844
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ELLIOT L PLOTKIN
Credential	:	DPM
Telephone Number	:	201-363-9844

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	07/15/2008

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