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NPI Code Detail

MEDICARE: MARY ELLEN JOAN FLANNERY PT

MEDICARE: MARY ELLEN JOAN FLANNERY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA00242300
2225100000XPhysical Therapist005166NY

General Provider Information

NPI Number : 1649390469
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ELLEN JOAN FLANNERY PT
Provider Business Mailing Address
First Line : 7 CARNEGIE PLZ
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08003-1000
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Provider Business Practice Location Address
First Line : 141 W 73RD ST
Second Line :
City : NEW YORK
State : NY
Zip : 10023-2916
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 03/14/2013

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Directions to “ MARY ELLEN JOAN FLANNERY PT” Practice Location

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