MEDICARE: BRENT FLUSTY D.O.

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	2085R0204X	Vascular & Interventional Radiology Physician	303263	NY
2	2084V0102X	Vascular Neurology Physician	303263	NY

General Provider Information

NPI Number	:	1669821088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENT FLUSTY D.O.

Provider Business Mailing Address
First Line	:	43 WESTMINSTER AVE
Second Line	:
City	:	BERGENFIELD
State	:	NJ
Zip	:	07621-3913
Country	:	US
Telephone Number	:	201-387-1957
Fax Number	:	201-351-0656

Provider Business Practice Location Address
First Line	:	211 61ST ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3782
Country	:	US
Telephone Number	:	718-630-1270
Fax Number	:	201-351-0656

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

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	05/13/2025

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