Provider Demographics
NPI:1033626072
Name:FLYNN, MEAGHAN MARIE
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:MARIE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 WASHINGTON ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5970
Mailing Address - Country:US
Mailing Address - Phone:978-729-6766
Mailing Address - Fax:
Practice Address - Street 1:1026 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2606
Practice Address - Country:US
Practice Address - Phone:518-489-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist