Healthcare Provider Details

I. General information

NPI: 1457775785
Provider Name (Legal Business Name): PLESSEN HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ORANGE GROVE
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

3004 ORANGE GROVE SUITE 2
CHRISTIANSTED VI
00820-4288
US

V. Phone/Fax

Practice location:
  • Phone: 340-715-7720
  • Fax: 340-713-9002
Mailing address:
  • Phone: 340-715-7720
  • Fax: 340-713-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateVI
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateVI
# 4
Primary TaxonomyN
Taxonomy Code207RH0005X
TaxonomyHypertension Specialist Physician
License Number
License Number StateVI
# 5
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateVI
# 6
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateVI
# 7
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateVI
# 8
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateVI
# 9
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateVI
# 10
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number StateVI
# 11
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateVI

VIII. Authorized Official

Name: DR. JAN BIJAN TAWAKOL
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 340-715-7720