Healthcare Provider Details

I. General information

NPI: 1801935648
Provider Name (Legal Business Name): MRS. JUEL H. PLOTKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 GENTIAN DR
WAKEFIELD RI
02879-1424
US

IV. Provider business mailing address

47 GENTIAN DR
WAKEFIELD RI
02879-1424
US

V. Phone/Fax

Practice location:
  • Phone: 401-932-0768
  • Fax:
Mailing address:
  • Phone: 401-783-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW00733
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number107090
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: