Healthcare Provider Details

I. General information

NPI: 1720004526
Provider Name (Legal Business Name): SCOTT N. PLOTKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 01/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3021
US

IV. Provider business mailing address

338 HARRIS HILL RD SUITE 207
WILLIAMSVILLE NY
14221-7470
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-3549
  • Fax: 716-898-5262
Mailing address:
  • Phone: 716-634-4798
  • Fax: 716-634-0987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number177070-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: