Provider Demographics
NPI:1881935674
Name:ELMER PLATZ
Entity type:Organization
Organization Name:ELMER PLATZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:R
Authorized Official - Last Name:PLATZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-764-6136
Mailing Address - Street 1:418 ROUTE 515
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-3027
Mailing Address - Country:US
Mailing Address - Phone:973-764-6136
Mailing Address - Fax:973-764-4515
Practice Address - Street 1:418 ROUTE 515
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3027
Practice Address - Country:US
Practice Address - Phone:973-764-6136
Practice Address - Fax:973-764-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ316634OtherMEDICARE
NJ650017122OtherMEDICARE