Healthcare Provider Details

I. General information

NPI: 1316954589
Provider Name (Legal Business Name): ALAN PLAUKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 DICKINSON ST
ELIZABETH NJ
07201-2210
US

IV. Provider business mailing address

520 N WOOD AVE
LINDEN NJ
07036-4147
US

V. Phone/Fax

Practice location:
  • Phone: 908-354-8900
  • Fax: 908-354-0007
Mailing address:
  • Phone: 908-587-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA51872
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: