Provider Demographics
NPI:1932111069
Name:NEVILLE A FLOWERS P T P C
Entity Type:Organization
Organization Name:NEVILLE A FLOWERS P T P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEVILLE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-525-8109
Mailing Address - Street 1:21910 S CONDUIT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3462
Mailing Address - Country:US
Mailing Address - Phone:718-525-8109
Mailing Address - Fax:718-527-3028
Practice Address - Street 1:219-10 S CONDUIT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413
Practice Address - Country:US
Practice Address - Phone:718-525-8109
Practice Address - Fax:718-527-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10355Medicare PIN