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General NPI Number Information
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NPI Number | 1356402473
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Entity Type | Individual
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Provider Name | LAURA PLOETZKE ANP
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 1 MERRITTS RD
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City | FARMINGDALE
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State | NY
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Zip | 11735-1817
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Country | US
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Telephone | 516-459-2939
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Fax | 516-586-4307
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Provider Business Mailing Address
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Address Line | 94 GARDINERS AVE STE 344
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City | LEVITTOWN
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State | NY
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Zip | 11756-3705
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Country | US
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Telephone | 516-847-1277
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Fax | 516-586-4307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F300672
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License Number State | NY
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