Provider Demographics
NPI:1609870245
Name:FLANZMAN, SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:FLANZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 OLD HOOK ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1377
Mailing Address - Country:US
Mailing Address - Phone:201-967-8221
Mailing Address - Fax:201-634-9647
Practice Address - Street 1:466 OLD HOOK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1377
Practice Address - Country:US
Practice Address - Phone:201-967-8221
Practice Address - Fax:201-634-9647
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06639500174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2461044OtherAETNA HMO ID #
NJ5816664OtherAETNA PPO ID #
NJF14508OtherHEALTHNET ID #
NJP907211OtherOXFORD ID #
NJ88F061OtherEMPIRE BC/BS OF NY ID #
NJ719343Medicare ID - Type UnspecifiedMEDICARE GROUP #
NJ88F061OtherEMPIRE BC/BS OF NY ID #
NJF14508OtherHEALTHNET ID #
E94708Medicare UPIN