MEDICARE: CHRISTINE C. PLATT M.D.

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	152W00000X	Optometrist	T0006558	NY
2	332H00000X	Eyewear Supplier	160134	NY
3	207W00000X	Ophthalmology Physician	160134	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	102473CR	OTHER	NY	PREFERRED CARE
3	P010160134	OTHER	NY	BLUE CHOICE
4	P010006558	OTHER	NY	BLUE CHOICE
5	110109CS	OTHER	NY	PREFERRED CARE
6	P030006558	OTHER	NY	BLUE SHIELD
7	7477432	OTHER	NY	AETNA
8	5930359	OTHER	NY	AETNA
9	8897	OTHER	NY	BLUE SHIELD
10	300238	OTHER	NY	WELLCARE

General Provider Information

NPI Number	:	1386827038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINE C. PLATT M.D.

Provider Business Mailing Address
First Line	:	1 LAKEVIEW PARK
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14613-1708
Country	:	US
Telephone Number	:	585-458-2020
Fax Number	:	585-458-3477

Provider Business Practice Location Address
First Line	:	1 LAKEVIEW PARK
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14613-1708
Country	:	US
Telephone Number	:	585-458-2020
Fax Number	:	585-458-3477

Authorized Official
Title or Position	:	BILLING MGR
Name	:	MRS. SHANON A BALLARD
Credential	:
Telephone Number	:	585-458-2020

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	05/11/2009

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