Basic Information
Provider Information
NPI: 1760405245
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PLUMER
FirstName: ALAN
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 COATES DR
Address2:  
City: GOSHEN
State: NY
PostalCode: 109246758
CountryCode: US
TelephoneNumber: 8456511400
FaxNumber: 8456511512
Practice Location
Address1: 30 HATFIELD LN
Address2: STE 107
City: GOSHEN
State: NY
PostalCode: 109246766
CountryCode: US
TelephoneNumber: 8457038806
FaxNumber: 8457039058
Other Information
ProviderEnumerationDate: 07/25/2006
LastUpdateDate: 09/27/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X178772NYY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
98F051L66301 MEDICAREOTHER


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