Healthcare Provider Details

I. General information

NPI: 1841551884
Provider Name (Legal Business Name): MS. BERNICE JOYCE PLITNICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 GARDEN CITY PLZ STE 350
GARDEN CITY NY
11530-3358
US

IV. Provider business mailing address

430 SHORE RD APT 7G
LONG BEACH NY
11561-5351
US

V. Phone/Fax

Practice location:
  • Phone: 516-747-9030
  • Fax:
Mailing address:
  • Phone: 516-432-8378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: