Provider Demographics
NPI:1720018948
Name:PLAZA MEDICAL, P.C.
Entity Type:Organization
Organization Name:PLAZA MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:718-209-4455
Mailing Address - Street 1:6410 VETERANS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5639
Mailing Address - Country:US
Mailing Address - Phone:718-209-6400
Mailing Address - Fax:718-209-6060
Practice Address - Street 1:6410 VETERANS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5639
Practice Address - Country:US
Practice Address - Phone:718-209-6400
Practice Address - Fax:718-209-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097922-1207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty