Provider Demographics
NPI:1326543091
Name:PERAGALLO-FLYNN, LINDSEY (DO)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:PERAGALLO-FLYNN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:PERAGALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2125 ROUTE 88 E
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3273
Mailing Address - Country:US
Mailing Address - Phone:732-892-4548
Mailing Address - Fax:732-892-0961
Practice Address - Street 1:2125 ROUTE 88 E
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3273
Practice Address - Country:US
Practice Address - Phone:732-892-4548
Practice Address - Fax:732-892-0961
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11065300207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine