Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X005097 | NY |
NPI | 1013115823 |
---|---|
Provider Name | Dr. Martin Leonard Plutno |
First Address | Merrick, NY 11566-2718 |
Second Address | Merrick, NY 11566-2718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/07/2007 |