Provider Demographics
NPI:1710195961
Name:FLAXMAN ERLICH, DAENA MEREDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:DAENA
Middle Name:MEREDITH
Last Name:FLAXMAN ERLICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAENA
Other - Middle Name:MEREDITH
Other - Last Name:FLAXMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:305 NE 2ND AVE # 77
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3801
Mailing Address - Country:US
Mailing Address - Phone:856-761-4767
Mailing Address - Fax:
Practice Address - Street 1:305 NE 2ND AVE # 77
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3801
Practice Address - Country:US
Practice Address - Phone:856-761-4767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA08389000207R00000X
FL165676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0170721Medicaid
NJ0170721Medicaid