Provider Demographics
NPI:1033257738
Name:FLUSHING HOSPITAL DENTAL
Entity Type:Organization
Organization Name:FLUSHING HOSPITAL DENTAL
Other - Org Name:FLUSHING HOSPITAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:718-206-9888
Mailing Address - Street 1:111-20 MERRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:ST ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-206-9888
Mailing Address - Fax:718-206-3033
Practice Address - Street 1:4500 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2205
Practice Address - Country:US
Practice Address - Phone:718-670-5588
Practice Address - Fax:718-670-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243843Medicaid