Healthcare Provider Details

I. General information

NPI: 1780771170
Provider Name (Legal Business Name): LAWRENCE PLOTKIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 CENTRAL AVENUE
WESTFIELD NJ
07090-2540
US

IV. Provider business mailing address

715 CENTRAL AVENUE
WESTFIELD NJ
07090-2540
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-3346
  • Fax: 908-232-6920
Mailing address:
  • Phone: 908-232-3346
  • Fax: 908-232-6920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMD1080
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: