Provider Demographics
NPI:1467836593
Name:FLANCBAUM, MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:FLANCBAUM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MEIR
Other - Middle Name:
Other - Last Name:FLANCBAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:131 BENNER ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2206
Mailing Address - Country:US
Mailing Address - Phone:201-696-0655
Mailing Address - Fax:
Practice Address - Street 1:2 TOWER CENTER BLVD
Practice Address - Street 2:SUITE 1943
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1100
Practice Address - Country:US
Practice Address - Phone:732-867-8427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5219103TC0700X
NY020324103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical