Healthcare Provider Details

I. General information

NPI: 1932111069
Provider Name (Legal Business Name): NEVILLE A FLOWERS P T P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219-10 S CONDUIT AVE
SPRINGFIELD GARDENS NY
11413
US

IV. Provider business mailing address

21910 S CONDUIT AVE
SPRINGFIELD GARDENS NY
11413-3462
US

V. Phone/Fax

Practice location:
  • Phone: 718-525-8109
  • Fax: 718-527-3028
Mailing address:
  • Phone: 718-525-8109
  • Fax: 718-527-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NEVILLE ANTHONY FLOWERS
Title or Position: OWNER
Credential: PT
Phone: 718-525-8109