Provider Demographics
NPI:1952504581
Name:FLAKOWITZ, DEBRA L (LPN)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:L
Last Name:FLAKOWITZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ABBEY CT
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3039
Mailing Address - Country:US
Mailing Address - Phone:516-857-1058
Mailing Address - Fax:
Practice Address - Street 1:6 ABBEY CT
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3039
Practice Address - Country:US
Practice Address - Phone:516-857-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259365-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02069845Medicaid