Healthcare Provider Details

I. General information

NPI: 1891741229
Provider Name (Legal Business Name): SHARI JOHNSON-PLOUTZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ASSOCIATE DR
ONEONTA NY
13820-2266
US

IV. Provider business mailing address

1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

V. Phone/Fax

Practice location:
  • Phone: 607-432-5680
  • Fax: 607-432-5575
Mailing address:
  • Phone: 607-547-3480
  • Fax: 607-547-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number006094
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: