Provider Demographics
NPI:1154706927
Name:PLATT PSYCHIATRIC ASSOCIATES, L.L.C.
Entity type:Organization
Organization Name:PLATT PSYCHIATRIC ASSOCIATES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PLATT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-239-4848
Mailing Address - Street 1:904 POMPTON AVE
Mailing Address - Street 2:B2
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1262
Mailing Address - Country:US
Mailing Address - Phone:973-239-4848
Mailing Address - Fax:973-239-4704
Practice Address - Street 1:904 POMPTON AVE
Practice Address - Street 2:B2
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1262
Practice Address - Country:US
Practice Address - Phone:973-239-4848
Practice Address - Fax:973-239-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB029029002084P0800X
NJ25MB029030002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty