| | Physician Last Name: | Plaza Medical & Pain Treatment |
| | Physician First Name: | P.C. |
| | Physician Middle Name: | |
| | Address: | Ruskin,Moscou,Evans and Faltichek,P.C.
c/o Gregory J.Naclerio, Esq.
East Tower 15th Floor
190 EAB Plaza
Uniondale, New York 11556 |
| | License Number: | 171302 |
| | License Type: | |
| | Year of Birth: |
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| | Effective Date: | 07/18/2002 |
| | Action Description for DOH Webpage: | Revocation of certificate of incorporation |
| | Misconduct Description for DOH Webpage: | The corporation admitted to the charge of willfully failing to comply with substantial provisions of State laws governing the practice of medicine. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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