Healthcare Provider Details

I. General information

NPI: 1356398044
Provider Name (Legal Business Name): LAURIE H PLOTNICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTREAL CHILDREN'S HOSPITAL 2300 TUPPER T-125
MONTREAL QC
H3H1P3
CA

IV. Provider business mailing address

3465 MARLOWE AVENUE
MONTREAL QC
H4A3L8
CA

V. Phone/Fax

Practice location:
  • Phone: 514-412-4400
  • Fax:
Mailing address:
  • Phone: 514-412-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number223959
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: