Healthcare Provider Details

I. General information

NPI: 1720169949
Provider Name (Legal Business Name): ZOILA R. FLASHNER, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 BROADWAY
AMITYVILLE NY
11701-2716
US

IV. Provider business mailing address

365 BROADWAY
AMITYVILLE NY
11701-2716
US

V. Phone/Fax

Practice location:
  • Phone: 631-789-2556
  • Fax: 631-789-2554
Mailing address:
  • Phone: 631-789-2556
  • Fax: 631-789-2554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2037231
License Number StateNY

VIII. Authorized Official

Name: DR. ZOILA ROCIO FLASHNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 631-789-2556