Provider Demographics
NPI:1477539682
Name:KAPLAN, MORTON (OD)
Entity Type:Individual
Prefix:
First Name:MORTON
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-6905
Mailing Address - Country:US
Mailing Address - Phone:201-906-4845
Mailing Address - Fax:914-737-8167
Practice Address - Street 1:1865 MAIN ST
Practice Address - Street 2:BEACH SHOPPING CENTER
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2505
Practice Address - Country:US
Practice Address - Phone:914-737-0437
Practice Address - Fax:914-737-8167
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2675T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00511913Medicaid
NY132891813OtherTIN NUMBER
NYC61151Medicare ID - Type UnspecifiedMEDICARE ID
NY132891813OtherTIN NUMBER