Provider Demographics
NPI:1669511077
Name:FLANAGAN, CATHRYN M (ND)
Entity Type:Individual
Prefix:DR
First Name:CATHRYN
Middle Name:M
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SPENCER PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-4000
Mailing Address - Country:US
Mailing Address - Phone:860-399-1212
Mailing Address - Fax:860-399-1228
Practice Address - Street 1:12 SPENCER PLAIN RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-4000
Practice Address - Country:US
Practice Address - Phone:860-399-1212
Practice Address - Fax:860-399-1228
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000137175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTOR 3046OtherHEALTHNET
110000137CT02OtherBLUECROSSBLUESHIELD
CT702592OtherCONNECTICARE