Healthcare Provider Details

I. General information

NPI: 1053451088
Provider Name (Legal Business Name): JONATHAN SCOTT KAPLAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RED SCHOOLHOUSE RD DOWNSTATE CORRECTIONAL FACILITY
FISHKILL NY
12524-2843
US

IV. Provider business mailing address

317 TOWN VIEW DR
WAPPINGERS FALLS NY
12590-7028
US

V. Phone/Fax

Practice location:
  • Phone: 315-765-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number211020
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: