Provider Demographics
NPI:1447299102
Name:PLESSET, MAXWELL B (MD)
Entity type:Individual
Prefix:
First Name:MAXWELL
Middle Name:B
Last Name:PLESSET
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:90 S BEDFORD RD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3412
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:1825 COMMERCE ST
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4432
Practice Address - Country:US
Practice Address - Phone:914-962-5060
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-11-13
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Provider Licenses
StateLicense IDTaxonomies
NY120271207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00332361Medicaid
NYB13395Medicare UPIN
NY3403006761Medicare PIN