Healthcare Provider Details

I. General information

NPI: 1851787683
Provider Name (Legal Business Name): LEV PLATSMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 COLON AVE
STATEN ISLAND NY
10308-1419
US

IV. Provider business mailing address

453 COLON AVE
STATEN ISLAND NY
10308-1419
US

V. Phone/Fax

Practice location:
  • Phone: 718-948-2121
  • Fax:
Mailing address:
  • Phone: 718-948-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number294769
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: