Provider Demographics
NPI:1558582775
Name:PLATT, STEVEN J (MPT,ATC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:PLATT
Suffix:
Gender:M
Credentials:MPT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:609-324-1200
Mailing Address - Fax:
Practice Address - Street 1:23659 COLUMBUS RD STE 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-1979
Practice Address - Country:US
Practice Address - Phone:609-324-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00982900208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ900148721OtherTAX ID
NJ093689Medicare ID - Type Unspecified