Provider Demographics
NPI:1740205509
Name:KAPLAN, MITCHEL ALAN
Entity Type:Individual
Prefix:
First Name:MITCHEL
Middle Name:ALAN
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THREE BARKER AVENUE
Mailing Address - Street 2:PARK AVENUE MEDICAL ASSOCIATES PC 4TH FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:914-949-1199
Mailing Address - Fax:914-949-1245
Practice Address - Street 1:THREE BARKER AVENUE
Practice Address - Street 2:PARK AVENUE MEDICAL ASSOCIATES PC 4TH FLOOR
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-949-1199
Practice Address - Fax:914-949-1245
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124108207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0480835OtherEVERCARE
NY00547782Medicaid
0340EGOtherMCARE GHI
0340EGOtherMCARE GHI
0480835OtherEVERCARE