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General NPI Number Information
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NPI Number | 1558961581
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Entity Type | Individual
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Provider Name | ANASTASIA PLATONOVA FNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 2379 RALPH AVE
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City | BROOKLYN
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State | NY
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Zip | 11234-5516
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Country | US
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Telephone | 718-942-4682
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Fax | 718-942-4683
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Provider Business Mailing Address
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Address Line | 75 OCEANA DR E APT 3H
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City | BROOKLYN
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State | NY
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Zip | 11235-6671
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Country | US
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Telephone | 347-634-4021
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 346791-01
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License Number State | NY
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