=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487808663
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOUGLAS FRANK PLATH PH.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2008
-----------------------------------------------------
Last Update Date | 11/19/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 280 DOBBS FERRY RD SUITE 200
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10607-1900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-997-2668
-----------------------------------------------------
Fax | 845-208-2080
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 280 DOBBS FERRY RD SUITE 200
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10607-1900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-997-2668
-----------------------------------------------------
Fax | 845-208-2080
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | 00013740
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | DCMH 06890
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------