Healthcare Provider Details

I. General information

NPI: 1568042687
Provider Name (Legal Business Name): NAVI PLAHA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 OLD COUNTRY RD
PLAINVIEW NY
11803-4914
US

IV. Provider business mailing address

2040 MILLBURN AVE
MAPLEWOOD NJ
07040-3726
US

V. Phone/Fax

Practice location:
  • Phone: 516-719-2543
  • Fax: 516-719-2766
Mailing address:
  • Phone: 973-996-2990
  • Fax: 908-242-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MB13245900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: