Provider Demographics
NPI:1598446874
Name:PLANKL, KIMBERLY (MS ED)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:PLANKL
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GREENVALE DR
Mailing Address - Street 2:
Mailing Address - City:E NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4112
Mailing Address - Country:US
Mailing Address - Phone:631-402-4337
Mailing Address - Fax:
Practice Address - Street 1:7 GREENVALE DR
Practice Address - Street 2:
Practice Address - City:E NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4112
Practice Address - Country:US
Practice Address - Phone:631-402-4337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist