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NPI Code Detail

MEDICARE: KONSTANTIN PLAKSIN PA

MEDICARE: KONSTANTIN PLAKSIN PA
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
1363A00000XPhysician Assistant035609NY

General Provider Information

NPI Number : 1801745146
Entity Type Code : Individual
Provider Name (Legal Business Name) : KONSTANTIN PLAKSIN PA
Provider Business Mailing Address
First Line : 3015 BRIGHTON 13TH ST APT 1J
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-5414
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 WOODS RD
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1530
Country : US
Telephone Number : 347-276-8782
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2026
Last Update Date : 03/29/2026

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Directions to “ KONSTANTIN PLAKSIN PA” Practice Location

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