Provider Demographics
NPI:1659967347
Name:FLAITZ, KAITLYN NICOLE (DC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:NICOLE
Last Name:FLAITZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S BEDFORD RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3456
Mailing Address - Country:US
Mailing Address - Phone:607-382-0915
Mailing Address - Fax:914-666-3374
Practice Address - Street 1:101 S BEDFORD RD STE 204
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3456
Practice Address - Country:US
Practice Address - Phone:607-382-0915
Practice Address - Fax:914-666-3374
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002208111N00000X
NYX013576-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor