Provider Demographics
NPI:1649748088
Name:FLAHERTY, ANN (FNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 TROUTMAN ST APT 4-4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-2645
Mailing Address - Country:US
Mailing Address - Phone:908-591-3453
Mailing Address - Fax:
Practice Address - Street 1:449 TROUTMAN ST APT 4-4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-2645
Practice Address - Country:US
Practice Address - Phone:908-591-3453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343643-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily