Provider Demographics
NPI:1457582124
Name:MIKHAIL PLOTNITSKIY, D.O., P.C.
Entity Type:Organization
Organization Name:MIKHAIL PLOTNITSKIY, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-897-0708
Mailing Address - Street 1:265 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3222
Mailing Address - Country:US
Mailing Address - Phone:516-897-0708
Mailing Address - Fax:516-431-4107
Practice Address - Street 1:265 W PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3222
Practice Address - Country:US
Practice Address - Phone:516-897-0708
Practice Address - Fax:516-431-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245179207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty