Provider Demographics
NPI:1093742942
Name:PLATZMAN, MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PLATZMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GLEN HILL LANE
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591
Mailing Address - Country:US
Mailing Address - Phone:914-366-8038
Mailing Address - Fax:
Practice Address - Street 1:4960 BROADWAY APT 1C
Practice Address - Street 2:NEW YORK FAMILY PRACTICE, PLLC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-2324
Practice Address - Country:US
Practice Address - Phone:212-304-0682
Practice Address - Fax:212-569-1967
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY210846207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01861852Medicaid
G76936Medicare UPIN
NY01861852Medicaid