Provider Demographics
NPI:1710943154
Name:FLORES, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:184 S LIVINGSTON AVE
Mailing Address - Street 2:STE 9 BOX 343
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3014
Mailing Address - Country:US
Mailing Address - Phone:201-795-9155
Mailing Address - Fax:201-795-9157
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:STE 470
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-918-2239
Practice Address - Fax:201-918-2243
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2013-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA46549207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5069203Medicaid
NJ5069203Medicaid
E03405Medicare UPIN