Provider Demographics
NPI: | 1851776082 |
---|---|
Name: | ALICIA MASSOP FLOWERS, D.O. P.C. |
Entity Type: | Organization |
Organization Name: | ALICIA MASSOP FLOWERS, D.O. P.C. |
Other - Org Name: | MVP MULTI MEDICAL |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CHIEF MEDICAL OFFICER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ALICIA |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | MASSOP-FLOWERS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 718-233-2556 |
Mailing Address - Street 1: | 13130 MERRICK BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | JAMAICA |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11434-4134 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-233-2556 |
Mailing Address - Fax: | 718-233-2569 |
Practice Address - Street 1: | 13130 MERRICK BLVD |
Practice Address - Street 2: | |
Practice Address - City: | JAMAICA |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11434-4134 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-233-2556 |
Practice Address - Fax: | 718-233-2569 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-07-29 |
Last Update Date: | 2015-07-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP1600X | Behavioral Health & Social Service Providers | Counselor | Pastoral | Group - Multi-Specialty |
No | 1223P0221X | Dental Providers | Dentist | Pediatric Dentistry | Group - Multi-Specialty |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 133VN1004X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | Group - Multi-Specialty |
No | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | Group - Multi-Specialty |