Provider Demographics
NPI:1811942972
Name:PLATT, RONALD ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ALAN
Last Name:PLATT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:42 S 15TH ST
Mailing Address - Street 2:SUITE 1720
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2218
Mailing Address - Country:US
Mailing Address - Phone:215-567-0580
Mailing Address - Fax:215-567-0584
Practice Address - Street 1:42 S 15TH ST
Practice Address - Street 2:SUITE 1720
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2218
Practice Address - Country:US
Practice Address - Phone:215-567-0580
Practice Address - Fax:215-567-0584
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000892152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000658173Medicare ID - Type Unspecified