Individual
DR. GREGORY J FLAITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
235
AK
152W00000X
Optometrist
558
SD
152W00000X
Optometrist
Primary
RT006640
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000538823002
BCBS
NY
05
—
04372932
—
NY
01
—
10566229
IHA
NY
01
—
4107243
AMERIGROUP
NY
01
—
430083
MEDICARE ID
SD
Enumeration date
05/12/2006
Last updated
04/21/2025
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