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General NPI Number Information
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NPI Number | 1184826885
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Entity Type | Individual
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Provider Name | ANDREW E FLICKER PT
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 245 WEST 104TH APT 7E
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City | NEW YORK
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State | NY
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Zip | 10025
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Country | US
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Telephone | 917-992-8552
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Fax |
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Provider Business Mailing Address
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Address Line | 245 W 104TH ST APT 7E
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City | NEW YORK
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State | NY
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Zip | 10025-4249
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Country | US
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Telephone | 917-992-8552
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0183591
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License Number State | NY
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