Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 198963-1 | NY |
NPI | 1043621261 |
---|---|
Provider Name | Dr. Ann-Marie Plate |
First Address | Lake Harmony, PA 18624-0754 |
Second Address | Lake Harmony, PA 18624-0754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2014 |
Last Update Date | 09/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198963-1 | NYS MEDICAL LICENSE (01) | NY |