Healthcare Provider Details

I. General information

NPI: 1235218355
Provider Name (Legal Business Name): STEVEN M PLOTYCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WEST END AVE #1P
NEW YORK NY
10023
US

IV. Provider business mailing address

205 WEST END AVE #1P
NEW YORK NY
10023
US

V. Phone/Fax

Practice location:
  • Phone: 212-724-4430
  • Fax: 212-724-6938
Mailing address:
  • Phone: 212-724-4430
  • Fax: 212-724-6938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number154825
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: