Provider Demographics
NPI:1962515825
Name:KAPLAN, CARL PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:PHILIP
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-444-0650
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF PEDIATRICS STONY BROOK UNIVERSITY
Practice Address - Street 2:HSC T-11, ROOM 020
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8111
Practice Address - Country:US
Practice Address - Phone:631-444-8014
Practice Address - Fax:631-444-7865
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2015-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY227696208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02663445Medicaid
NY02663445Medicaid
NY1531Q1Medicare ID - Type Unspecified