Healthcare Provider Details

I. General information

NPI: 1538030978
Provider Name (Legal Business Name): ELIYOHU PLOPPER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 ELM AVE
BROOKLYN NY
11230-5914
US

IV. Provider business mailing address

1210 ELM AVE
BROOKLYN NY
11230-5914
US

V. Phone/Fax

Practice location:
  • Phone: 845-709-3212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number356393
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: