Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 141643 | NY |
NPI | 1013901024 |
---|---|
Provider Name | Mark Flugman |
First Address | Rockville Centre, NY 11570-3800 |
Second Address | Rockville Centre, NY 11570-3800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 10/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00831829 | (05) | NY |
0092460 | GHI ID # (01) | NY |
0098128 | AETNA US HEALTHCARE # (01) | NY |
6531 | VYTRA ID # (01) | NY |
A99179 | (02) | |
AS677 | OXFORD ID # (01) | NY |