Healthcare Provider Details

I. General information

NPI: 1750245916
Provider Name (Legal Business Name): KAVANAH MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 E EVERGREEN RD STE 101-213
NEW CITY NY
10956-5145
US

IV. Provider business mailing address

3 E EVERGREEN RD STE 101-213
NEW CITY NY
10956-5145
US

V. Phone/Fax

Practice location:
  • Phone: 646-854-8839
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN PLAUT
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 646-854-8839