Organization Name: | YOUR DOCTOR MEDICAL .PC |
NPI Number: | 1285882209 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALLA PLOTKINA (OWNER) |
Mailing Address: | 3057 Coney Island Ave Brooklyn |
State: | NY US |
Postal Code: | 112356320 |
Phone Number: | 7186485858 |
Fax Number: | 7183752735 |
NPI Enumeration Date: | 09/03/2008 |
NPI Last Update Date: | 09/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 212752 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |