Provider Demographics
NPI:1578298204
Name:FLATOW, BETH (RDH)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:
Last Name:FLATOW
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-1845
Mailing Address - Country:US
Mailing Address - Phone:516-378-2000
Mailing Address - Fax:516-377-2098
Practice Address - Street 1:UNITED CEREBRAL PALSY ASSOCIATION OF NASSAU COUNTY, INC
Practice Address - Street 2:380 WASHINGTON AVE
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1845
Practice Address - Country:US
Practice Address - Phone:516-378-2000
Practice Address - Fax:516-377-2098
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01933601124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist