Provider Demographics
NPI:1811983257
Name:PLISKIN, DORIS C (MD)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:C
Last Name:PLISKIN
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 1:33 BARTLETT ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1334
Mailing Address - Country:US
Mailing Address - Phone:978-458-4300
Mailing Address - Fax:978-458-4311
Practice Address - Street 1:33 BARTLETT ST
Practice Address - Street 2:SUITE 503
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1334
Practice Address - Country:US
Practice Address - Phone:978-458-4300
Practice Address - Fax:978-458-4311
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46490174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA230000004OtherRAILROAD MEDICARE
MA21395OtherFALLON COMMUNITY HEALTH
MA700772OtherSECURE HORIZONS
MADO B26239OtherBLUE SHIELD
MA3523268OtherAETNA
MA8563OtherHARVARD PILGRIM
MA982171OtherNETWORK HEALTH
MA17-00081OtherUNITED HEALTHCARE
MA700772OtherTUFTS HEALTH PLAN
MA0115827Medicaid
MAB26239Medicare ID - Type Unspecified
MA0115827Medicaid