Provider Demographics
NPI:1629204326
Name:PLATT, ANNE BELLE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:BELLE
Last Name:PLATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 BEETHOVEN CT
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11941-1603
Mailing Address - Country:US
Mailing Address - Phone:631-801-2634
Mailing Address - Fax:
Practice Address - Street 1:127 BEETHOVEN CT
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:NY
Practice Address - Zip Code:11941-1603
Practice Address - Country:US
Practice Address - Phone:631-801-2634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153509207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E69926Medicare UPIN