Healthcare Provider Details

I. General information

NPI: 1629204326
Provider Name (Legal Business Name): ANNE BELLE PLATT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 BEETHOVEN CT
EASTPORT NY
11941-1603
US

IV. Provider business mailing address

127 BEETHOVEN CT
EASTPORT NY
11941-1603
US

V. Phone/Fax

Practice location:
  • Phone: 631-801-2634
  • Fax:
Mailing address:
  • Phone: 631-801-2634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number153509
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: