Provider Demographics
NPI:1033148929
Name:FLANNERY, TERRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:
Last Name:FLANNERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CORPORATE WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2345
Mailing Address - Country:US
Mailing Address - Phone:518-367-4736
Mailing Address - Fax:518-367-4218
Practice Address - Street 1:500 PATROON CREEK BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-5006
Practice Address - Country:US
Practice Address - Phone:518-641-3217
Practice Address - Fax:518-641-3209
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155434207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine