Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N002970 | NY |
N | 213ES0131X | Foot Surgery | N002970 | NY |
NPI | 1518962380 |
---|---|
Provider Name | Dr. Stuart Plotkin |
First Address | Port Jefferson Station, NY 11776-1598 |
Second Address | Port Jefferson Station, NY 11776-1598 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 06/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T50920 | (02) | NY |