Provider Demographics
NPI:1619471083
Name:FLAHERTY, MEAGHAN E (EMT-B)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:E
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 NOBSCOT BROOK LN
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-2743
Mailing Address - Country:US
Mailing Address - Phone:161-794-3106
Mailing Address - Fax:
Practice Address - Street 1:5 NOBSCOT BROOK LN
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-2743
Practice Address - Country:US
Practice Address - Phone:161-794-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2255A2300X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer