Provider Demographics
NPI:1710952213
Name:FLIS, RAYMOND STANLEY (DO)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:STANLEY
Last Name:FLIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 INDUSTRIAL WAY W
Mailing Address - Street 2:SUITE B
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2268
Mailing Address - Country:US
Mailing Address - Phone:732-460-1200
Mailing Address - Fax:732-460-1211
Practice Address - Street 1:6 INDUSTRIAL WAY W
Practice Address - Street 2:SUITE B
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2268
Practice Address - Country:US
Practice Address - Phone:732-460-1200
Practice Address - Fax:732-460-1211
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26473207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC59147Medicare UPIN