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General NPI Number Information
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NPI Number | 1245488337
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Entity Type | Organization
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Legal Business Name | WILLIAM F. FLADER MD, PLLC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 100 N COUNTRY RD
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City | SETAUKET
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State | NY
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Zip | 11733-1300
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Country | US
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Telephone | 631-941-3137
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N COUNTRY RD
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City | SETAUKET
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State | NY
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Zip | 11733-1300
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Country | US
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Telephone | 631-941-3137
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM F FLADER
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Credential | MD
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Telephone | 631-941-3137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 163266
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License Number State | OK
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