Healthcare Provider Details

I. General information

NPI: 1043620073
Provider Name (Legal Business Name): KAREN PLOTAS-MCGRATH PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 MARGARET STREET
PLATTSBURGH NY
12901
US

IV. Provider business mailing address

133 MARGARET ST
PLATTSBURGH NY
12901-2926
US

V. Phone/Fax

Practice location:
  • Phone: 518-565-4855
  • Fax: 518-565-4941
Mailing address:
  • Phone: 518-565-4855
  • Fax: 518-565-4941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number435882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: