Healthcare Provider Details

I. General information

NPI: 1255303228
Provider Name (Legal Business Name): RICHARD PLOTZKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S 54TH ST SUITE 126
PHILADELPHIA PA
19143-1900
US

IV. Provider business mailing address

501 S 54TH ST SUITE 126
PHILADELPHIA PA
19143-1900
US

V. Phone/Fax

Practice location:
  • Phone: 215-748-9872
  • Fax: 215-748-9869
Mailing address:
  • Phone: 215-748-9872
  • Fax: 215-748-9869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberC1-0002248
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: