Provider Demographics
NPI:1689668196
Name:PLOTKA, STEVEN DAVID (DPM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DAVID
Last Name:PLOTKA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 TAYLORS MILLS RD
Mailing Address - Street 2:STE 111
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3281
Mailing Address - Country:US
Mailing Address - Phone:732-780-7331
Mailing Address - Fax:732-972-2156
Practice Address - Street 1:224 TAYLORS MILLS RD
Practice Address - Street 2:STE 111
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3281
Practice Address - Country:US
Practice Address - Phone:732-780-7331
Practice Address - Fax:732-972-2156
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002461213ES0103X
NYN0055321213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPB0951Medicare ID - Type Unspecified
NYPB0951Medicare PIN
U72078Medicare UPIN
NJ017114Medicare PIN