MEDICARE: ADINA PLUTCHOK RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	N23593-01	NY

General Provider Information

NPI Number	:	1265362792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADINA PLUTCHOK RN

Provider Business Mailing Address
First Line	:	686 E 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-5604
Country	:	US
Telephone Number	:	347-222-6620
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 OLD COUNTRY RD
Second Line	:
City	:	RIVERHEAD
State	:	NY
Zip	:	11901-2198
Country	:	US
Telephone Number	:	347-222-6620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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