Provider Demographics
NPI:1881737757
Name:PLOTKINA, ALLA (DO)
Entity type:Individual
Prefix:DR
First Name:ALLA
Middle Name:
Last Name:PLOTKINA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6623
Mailing Address - Country:US
Mailing Address - Phone:718-974-0016
Mailing Address - Fax:718-477-7862
Practice Address - Street 1:2315 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6623
Practice Address - Country:US
Practice Address - Phone:718-974-0016
Practice Address - Fax:718-477-7862
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21275201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBP6186868OtherNYS DEA
NYBP6186868OtherNYS DEA
NYH46171Medicare UPIN