Provider Demographics
NPI:1972721066
Name:PLASKETT, TRACEY YVONNE (RN)
Entity type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:YVONNE
Last Name:PLASKETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10 W 135TH ST
Mailing Address - Street 2:APT 5U
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2602
Mailing Address - Country:US
Mailing Address - Phone:212-234-8588
Mailing Address - Fax:
Practice Address - Street 1:519 WEST 114TH ST, MC 3601
Practice Address - Street 2:JOHN JAY HALL,3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027
Practice Address - Country:US
Practice Address - Phone:212-854-9842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY416736-1163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health