Provider Demographics
NPI:1215196662
Name:JOHN C. FLANAGAN,M.D.
Entity Type:Organization
Organization Name:JOHN C. FLANAGAN,M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-535-8783
Mailing Address - Street 1:950 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1741
Mailing Address - Country:US
Mailing Address - Phone:212-535-8783
Mailing Address - Fax:718-442-3144
Practice Address - Street 1:950 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1741
Practice Address - Country:US
Practice Address - Phone:212-535-8783
Practice Address - Fax:718-442-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138470207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00861376Medicaid
A65136Medicare UPIN
NY97A251Medicare PIN