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Individual

MR. ELMER R PLATZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
418 STATE RT 515, VERNON, NJ 07462-3027
(973) 764-6136
(973) 764-4515
Mailing address
418 STATE RT 515, VERNON, NJ 07462-3027
(973) 764-6136
(973) 764-4515

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004018-1
NY
225100000X
Physical Therapist
Primary
40QA00133700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
222054583
TAX IDENTIFICATION NUMBER
NJ
01
EP0Q554810
EMPIRE BCBS PROVIDER NO.
NY
Enumeration date
12/13/2006
Last updated
01/15/2008
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