Provider Demographics
NPI:1023294600
Name:FLAHERTY, COLLEEN ANN (DO)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:ANN
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4 SNAKE ROAD
Mailing Address - Street 2:BUCKNELL UNIVERSITY ZIEGLER HEALTH CENTER
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837
Mailing Address - Country:US
Mailing Address - Phone:570-577-1401
Mailing Address - Fax:570-577-3570
Practice Address - Street 1:4 SNAKE ROAD
Practice Address - Street 2:BUCKNELL UNIVERSITY ZIEGLER STUDENT HEALTH CENTER
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837
Practice Address - Country:US
Practice Address - Phone:570-577-1401
Practice Address - Fax:570-577-3570
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS005554L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine