Provider Demographics
NPI:1750035333
Name:FLYNN, KAREN PANGONIS
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:PANGONIS
Last Name:FLYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:PANGONIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 E CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:MAHANOY CITY
Mailing Address - State:PA
Mailing Address - Zip Code:17948-2702
Mailing Address - Country:US
Mailing Address - Phone:570-773-3860
Mailing Address - Fax:570-773-3860
Practice Address - Street 1:15 E CENTRE ST
Practice Address - Street 2:
Practice Address - City:MAHANOY CITY
Practice Address - State:PA
Practice Address - Zip Code:17948-2702
Practice Address - Country:US
Practice Address - Phone:570-773-3860
Practice Address - Fax:570-773-3860
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037989L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist