Provider Demographics
NPI:1164661518
Name:FLORY, JANINE D (PHD)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:D
Last Name:FLORY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 KISSENA BLVD
Mailing Address - Street 2:NSB D312
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6530 KISSENA BLVD
Practice Address - Street 2:NSB D312
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1575
Practice Address - Country:US
Practice Address - Phone:718-997-3465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016055-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical