Provider Demographics
NPI:1861701591
Name:PLAISIMOND, CARL (LPN)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:PLAISIMOND
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEATLEY HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11798-2008
Mailing Address - Country:US
Mailing Address - Phone:631-926-7261
Mailing Address - Fax:
Practice Address - Street 1:87 EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1001
Practice Address - Country:US
Practice Address - Phone:631-926-7261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301130164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse