Provider Demographics
NPI:1700868270
Name:FLAMINIANO, LOURDES MARIE E (MD)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:MARIE E
Last Name:FLAMINIANO
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:PO BOX 130370
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-0995
Mailing Address - Country:US
Mailing Address - Phone:212-693-1800
Mailing Address - Fax:
Practice Address - Street 1:198 CANAL ST
Practice Address - Street 2:SUITE 602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-693-1800
Practice Address - Fax:212-693-1839
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10241800207RS0012X, 207RP1001X, 207RS0012X
MA160581207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2104440Medicaid
MAA3844001Medicare PIN
MA2104440Medicaid
MAH98842Medicare UPIN