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Individual

DR. FLAVIA GUSMANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
212 RIDGE RD, DOUGLASTON, NY 11363-1309
(718) 423-7788
(718) 229-2222
Mailing address
212 RIDGE RD, DOUGLASTON, NY 11363-1309
(718) 423-7788
(718) 229-2222

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
234942
NY
2086S0129X
Vascular Surgery Physician
Primary
234942
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02648864
NY
01
161881FL
PREFERRED CARE
NY
01
7172632
AETNA
NY
01
P010234942
BLUE CHOICE
NY
01
P020234942
BLUE CROSS BLUE SHIELD
NY
Enumeration date
07/03/2006
Last updated
10/28/2016
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