Individual
ETHAN G FLAKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5100 W TAFT RD, SUITE 1D, LIVERPOOL, NY 13088-3807
(315) 452-2829
(315) 452-2870
Mailing address
5100 W TAFT RD, SUITE 1D, LIVERPOOL, NY 13088-3807
(315) 452-2828
(315) 452-2870
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
146994
NY
207Q00000X
Family Medicine Physician
Primary
146994
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00730621
—
NY
Enumeration date
03/22/2006
Last updated
11/15/2011
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