Basic Information
| Provider Information | |||||||||
| NPI: | 1962470815 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLANAGAN | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 240 E 38TH ST FL 15 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100162708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122636037 | ||||||||
| FaxNumber: | 2122630418 | ||||||||
| Practice Location | |||||||||
| Address1: | 240 E 38TH ST FL 15 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100162708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122636037 | ||||||||
| FaxNumber: | 2122630418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 179663 | NY | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 225400000X | 179663 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 01381424 | 05 | NY | MEDICAID |