Provider Demographics
NPI:1467453043
Name:FLOMENHAFT, DAVID (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:FLOMENHAFT
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 SYDNEY AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1135
Mailing Address - Country:US
Mailing Address - Phone:516-596-0739
Mailing Address - Fax:516-596-0739
Practice Address - Street 1:96 SYDNEY AVE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1135
Practice Address - Country:US
Practice Address - Phone:516-596-0739
Practice Address - Fax:516-596-0739
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031673-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY29161OtherUNITED BEHAVIORAL HEALTH
NY7405449-003OtherGHI
NYP369743OtherOXFORD HEALTH PLANS
NY104355OtherMHN
NY059519OtherVALUE OPTIONS
NYPVPB79827OtherAMER. PSYCH SYS
NYPVPB79827OtherAMER. PSYCH SYS