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Individual

ELLIOT IRA KAPLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,PHD.

Contact information

Practice address
21 WILLOW POND WAY, STE 200, PENFIELD, NY 14526-2687
(585) 377-0840
(585) 377-9715
Mailing address
21 WILLOW POND WAY, STE 200, PENFIELD, NY 14526-2687
(585) 377-0840
(585) 377-9715

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
173626
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01132109
NY
01
01915
BLUE CROSS/BLUE SHIELD
NY
01
102554DL
PREFERRED CARE
NY
01
7570001
AETNA
NY
Enumeration date
07/13/2006
Last updated
07/08/2007
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