Provider Demographics
NPI:1790736866
Name:PLICHTA, ANNA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIA
Last Name:PLICHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DAVID RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-3008
Mailing Address - Country:US
Mailing Address - Phone:914-248-0124
Mailing Address - Fax:
Practice Address - Street 1:CASTLE POINT RD
Practice Address - Street 2:HVHCS - VA
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511-9902
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:845-838-5274
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171382207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01259407Medicaid
NY01259407Medicaid
NYAP88F571Medicare ID - Type Unspecified