Provider Demographics
NPI:1861496820
Name:FLAX, HAROLD M (FNP)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:M
Last Name:FLAX
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 ROUTE 50
Mailing Address - Street 2:PO BOX 569
Mailing Address - City:BURNT HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12027-0569
Mailing Address - Country:US
Mailing Address - Phone:518-831-1500
Mailing Address - Fax:518-280-8464
Practice Address - Street 1:848 ROUTE 50
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9511
Practice Address - Country:US
Practice Address - Phone:518-831-1500
Practice Address - Fax:518-280-8464
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332387-0363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner