=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699961169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HELEN S FLAMENBAUM MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2007
-----------------------------------------------------
Last Update Date | 06/13/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3003 NEW HYDE PARK RD
-----------------------------------------------------
City | NEW HYDE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11042-1214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-354-6868
-----------------------------------------------------
Fax | 516-352-6807
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3003 NEW HYDE PARK RD
-----------------------------------------------------
City | NEW HYDE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11042-1214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-354-6868
-----------------------------------------------------
Fax | 516-352-6807
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | HELEN FLAMENBAUM
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 516-354-6868
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 139010-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------