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General NPI Number Information
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NPI Number | 1457582124
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Entity Type | Organization
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Legal Business Name | MIKHAIL PLOTNITSKIY, D.O., P.C.
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 265 W PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-3222
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Country | US
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Telephone | 516-897-0708
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Fax | 516-431-4107
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Provider Business Mailing Address
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Address Line | 265 W PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-3222
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Country | US
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Telephone | 516-897-0708
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Fax | 516-431-4107
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS ERIN M HACK
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Credential |
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Telephone | 516-897-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 245179
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License Number State | NY
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