Healthcare Provider Details
I. General information
NPI: 1912668179
Provider Name (Legal Business Name): RIVKA FLIGMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/09/2022
Last Update Date: 03/11/2023
Certification Date: 03/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1352 RIVER AVE
LAKEWOOD NJ
08701-5646
US
IV. Provider business mailing address
1545 56 STREET
BROOKLYN NY
11219
US
V. Phone/Fax
- Phone: 732-370-5100
- Fax:
- Phone: 718-972-5921
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | F348660 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: