Provider Demographics
NPI:1063296853
Name:FLECKENSTEIN, ELENI (PT, DPT)
Entity type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:FLECKENSTEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 ATLANTIC AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-1870
Mailing Address - Country:US
Mailing Address - Phone:315-986-7248
Mailing Address - Fax:
Practice Address - Street 1:180 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5034
Practice Address - Country:US
Practice Address - Phone:646-543-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050707225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist