Provider Demographics
NPI:1821099391
Name:FLANNERY, MARGARET ANN (FAMILY NP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:FAMILY NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27036
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7036
Mailing Address - Country:US
Mailing Address - Phone:212-305-9576
Mailing Address - Fax:212-305-9480
Practice Address - Street 1:177 FORT WASHINGTON AVE
Practice Address - Street 2:MILSTEIN HOSPITAL 7GN-RM 435
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3733
Practice Address - Country:US
Practice Address - Phone:212-305-6003
Practice Address - Fax:212-305-0907
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331371-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY021040437Medicaid
NY564677Medicare UPIN
NY97V261Medicare ID - Type Unspecified
NYA400087185Medicare PIN