Provider Demographics
NPI:1023102142
Name:FLASHNER, SCOTT JAY (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JAY
Last Name:FLASHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-3439
Mailing Address - Country:US
Mailing Address - Phone:631-841-4102
Mailing Address - Fax:631-841-4104
Practice Address - Street 1:148 MERRICK RD
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-3439
Practice Address - Country:US
Practice Address - Phone:631-841-4102
Practice Address - Fax:631-841-4104
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186831207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY586053Medicare ID - Type Unspecified
NYG17349Medicare UPIN