Healthcare Provider Details

I. General information

NPI: 1265362792
Provider Name (Legal Business Name): ADINA PLUTCHOK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 OLD COUNTRY RD
RIVERHEAD NY
11901-2198
US

IV. Provider business mailing address

686 E 2ND ST
BROOKLYN NY
11218-5604
US

V. Phone/Fax

Practice location:
  • Phone: 347-222-6620
  • Fax:
Mailing address:
  • Phone: 347-222-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN23593-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: