Provider Demographics
NPI:1386827038
Name:CHRISTINE C. PLATT M.D.
Entity Type:Organization
Organization Name:CHRISTINE C. PLATT M.D.
Other - Org Name:LAKEVIEW EYECARE
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANON
Authorized Official - Middle Name:A
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-458-2020
Mailing Address - Street 1:1 LAKEVIEW PARK
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1708
Mailing Address - Country:US
Mailing Address - Phone:585-458-2020
Mailing Address - Fax:585-458-3477
Practice Address - Street 1:1 LAKEVIEW PARK
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1708
Practice Address - Country:US
Practice Address - Phone:585-458-2020
Practice Address - Fax:585-458-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT0006558152W00000X
NY160134207W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01038619Medicaid
NY102473CROtherPREFERRED CARE
NYP010160134OtherBLUE CHOICE
NYP010006558OtherBLUE CHOICE
NY110109CSOtherPREFERRED CARE
NYP030006558OtherBLUE SHIELD
NY7477432OtherAETNA
NY5930359OtherAETNA
NY8897OtherBLUE SHIELD
NY300238OtherWELLCARE
NYP030006558OtherBLUE SHIELD
NY7477432OtherAETNA
NY110109CSOtherPREFERRED CARE
NYU91688Medicare UPIN
NY5930359OtherAETNA
NYDD2047Medicare PIN