Provider Demographics
NPI:1912985904
Name:FLANIGEN, DIANE T (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:T
Last Name:FLANIGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6333 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5800
Mailing Address - Country:US
Mailing Address - Phone:716-632-3545
Mailing Address - Fax:716-632-6368
Practice Address - Street 1:6333 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5800
Practice Address - Country:US
Practice Address - Phone:716-632-3545
Practice Address - Fax:716-632-6368
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178565-1207W00000X
NY178565207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010056503OtherUNIVERA
NY0809877OtherIHA
NY000511177008OtherHEALTH NOW
NY01154094Medicaid
NY161000580OtherEMPIRE PLAN
NY161000580OtherNORTH AMERICAN PREFERRED
NY000511177008OtherHEALTH NOW
NYE93055Medicare UPIN