Provider Demographics
NPI:1508467218
Name:PLATON, CRISTINA V
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:V
Last Name:PLATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BUREAU DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1402
Mailing Address - Country:US
Mailing Address - Phone:301-840-0815
Mailing Address - Fax:
Practice Address - Street 1:46 BUREAU DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1402
Practice Address - Country:US
Practice Address - Phone:301-840-0815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist