Provider Demographics
NPI:1437243243
Name:FLYNN, ELLEN M (NP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:FLYNN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:555 KAPPOCK ST
Mailing Address - Street 2:14P
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:718-432-9381
Mailing Address - Fax:718-432-9381
Practice Address - Street 1:34 ROUTE 403
Practice Address - Street 2:GERGELY PEDIATRICS
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524
Practice Address - Country:US
Practice Address - Phone:845-424-4444
Practice Address - Fax:845-424-4664
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY195210163W00000X
NY038219363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner