Provider Demographics
NPI:1669447546
Name:PLATT, CHRISTINE C (MD, PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:PLATT
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3130
Mailing Address - Country:US
Mailing Address - Phone:585-461-2017
Mailing Address - Fax:
Practice Address - Street 1:1 LAKEVIEW PARK
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1708
Practice Address - Country:US
Practice Address - Phone:585-458-2020
Practice Address - Fax:585-458-3477
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160134174400000X, 332H00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5930359OtherAETNA
NY8897OtherBLUE SHIELD
NY300238OtherWELLCARE
NY01038619Medicaid
NY161305396OtherPRINCIPAL
NYP010160134OtherBLUE CHOICE
NY102473CROtherPREFERRED CARE
NY161305396OtherPHCS
NY161305396OtherUNITED HEALTH CARE
NYP010160134OtherBLUE CHOICE
NY8897OtherBLUE SHIELD
NYB72149Medicare UPIN