Healthcare Provider Details

I. General information

NPI: 1073149589
Provider Name (Legal Business Name): FLATIRON MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 BROADWAY STE 1106
NEW YORK NY
10010-7127
US

IV. Provider business mailing address

915 BROADWAY STE 1106
NEW YORK NY
10010-7127
US

V. Phone/Fax

Practice location:
  • Phone: 212-333-4884
  • Fax: 212-475-4443
Mailing address:
  • Phone: 212-475-8104
  • Fax: 212-475-4443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KHADIJA CONLEY
Title or Position: BILLING
Credential:
Phone: 646-246-6919