MEDICARE: DR. SUSAN FLANZMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25MA06639500	NJ
2	207R00000X	Internal Medicine Physician	25MA06639500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2461044	OTHER	NJ	AETNA HMO ID #
2	5816664	OTHER	NJ	AETNA PPO ID #
3	F14508	OTHER	NJ	HEALTHNET ID #
4	P907211	OTHER	NJ	OXFORD ID #
5	88F061	OTHER	NJ	EMPIRE BC/BS OF NY ID #

General Provider Information

NPI Number	:	1609870245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN FLANZMAN MD

Provider Business Mailing Address
First Line	:	466 OLD HOOK ROAD
Second Line	:	SUITE 1
City	:	EMERSON
State	:	NJ
Zip	:	07630-1377
Country	:	US
Telephone Number	:	201-967-8221
Fax Number	:	201-634-9647

Provider Business Practice Location Address
First Line	:	466 OLD HOOK RD
Second Line	:	SUITE 1
City	:	EMERSON
State	:	NJ
Zip	:	07630-1377
Country	:	US
Telephone Number	:	201-967-8221
Fax Number	:	201-634-9647

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	12/19/2012

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Directions to “ DR. SUSAN FLANZMAN MD” Practice Location

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