Provider Demographics
NPI:1598094336
Name:FLAXMAN, JUDITH S
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:S
Last Name:FLAXMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JUDIT
Other - Middle Name:ANNE
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7520 ASTORIA BLVD
Mailing Address - Street 2:BULOVA CORPORATE CENTER, SUITE 212
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1138
Mailing Address - Country:US
Mailing Address - Phone:718-888-6920
Mailing Address - Fax:
Practice Address - Street 1:7520 ASTORIA BLVD
Practice Address - Street 2:BULOVA CORPORATE CENTER, SUITE 212
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1138
Practice Address - Country:US
Practice Address - Phone:718-888-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0075712251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics