Provider Demographics
NPI:1538480678
Name:DR. DAVID PLOTKIN P.A.
Entity Type:Organization
Organization Name:DR. DAVID PLOTKIN P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOTKIN
Authorized Official - Suffix:
Authorized Official - Credentials:FACFAS
Authorized Official - Phone:973-379-9333
Mailing Address - Street 1:619 MORRIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1511
Mailing Address - Country:US
Mailing Address - Phone:973-379-9333
Mailing Address - Fax:973-215-1668
Practice Address - Street 1:619 MORRIS AVENUE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1511
Practice Address - Country:US
Practice Address - Phone:973-379-9333
Practice Address - Fax:973-215-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ000972213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T44751Medicare UPIN
134214Medicare PIN