Provider Demographics
NPI:1689562308
Name:PLATT, MARLISS
Entity type:Individual
Prefix:
First Name:MARLISS
Middle Name:
Last Name:PLATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E ELIZABETH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3032
Mailing Address - Country:US
Mailing Address - Phone:910-574-6382
Mailing Address - Fax:
Practice Address - Street 1:27 E ELIZABETH AVE APT 3
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-3032
Practice Address - Country:US
Practice Address - Phone:910-574-6382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator