Provider Demographics
NPI:1225015480
Name:FLAHERTY, KARA (MD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-7680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3191
Practice Address - Country:US
Practice Address - Phone:802-879-1802
Practice Address - Fax:802-878-6131
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT42-0010570207V00000X
VT042.0010570174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT7102201OtherVERMONT MANAGED CARE
VT00059500OtherBCBS
VT1009558Medicaid
VT363285OtherMVP
VT7102201OtherVERMONT MANAGED CARE
VTVN3191Medicare ID - Type Unspecified