Provider Demographics
NPI:1659342632
Name:FLICKSTEIN, SANDRA (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:FLICKSTEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:FLICKSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:52 STEERS ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6310
Mailing Address - Country:US
Mailing Address - Phone:718-494-0376
Mailing Address - Fax:718-698-6970
Practice Address - Street 1:2350 OCEAN AVE
Practice Address - Street 2:BAY PHYSICAL THERAPY, SUITE 5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3044
Practice Address - Country:US
Practice Address - Phone:718-998-7586
Practice Address - Fax:718-998-3374
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00282826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ52112Medicare ID - Type UnspecifiedPHYSICAL THERAPY