Provider Demographics
NPI:1497978522
Name:FLEXICARE PT SERVICES, PC
Entity Type:Organization
Organization Name:FLEXICARE PT SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIANO LAZCANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-615-0800
Mailing Address - Street 1:5852 43RD AVE
Mailing Address - Street 2:APT# 2R
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4852
Mailing Address - Country:US
Mailing Address - Phone:718-305-2173
Mailing Address - Fax:718-305-2173
Practice Address - Street 1:308 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6845
Practice Address - Country:US
Practice Address - Phone:718-615-0800
Practice Address - Fax:866-419-7618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024082-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy