Healthcare Provider Details

I. General information

NPI: 1104115724
Provider Name (Legal Business Name): HAROLD FLAMER, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13627 71ST RD
FLUSHING NY
11367-1942
US

IV. Provider business mailing address

13627 71ST RD
FLUSHING NY
11367-1942
US

V. Phone/Fax

Practice location:
  • Phone: 718-268-3979
  • Fax: 718-268-3979
Mailing address:
  • Phone: 718-268-3979
  • Fax: 718-268-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number211806
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number211806
License Number StateNY

VIII. Authorized Official

Name: DR. HAROLD FLAMER
Title or Position: DIRECTOR
Credential: M.D.
Phone: 718-268-3979