Healthcare Provider Details

I. General information

NPI: 1679510119
Provider Name (Legal Business Name): SIDNEY PLAWES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 KIMBALL STREET SUITE 210
BROOKLYN NY
11234-5139
US

IV. Provider business mailing address

2270 KIMBALL STREET SUITE 210
BROOKLYN NY
11234-5139
US

V. Phone/Fax

Practice location:
  • Phone: 718-692-2700
  • Fax: 347-274-0676
Mailing address:
  • Phone: 718-692-2700
  • Fax: 347-274-0676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number158962
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number1589621
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: