MEDICARE: EILEEN BRIDGET FLYNN RICHARDS NP

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
1	363LA2200X	Adult Health Nurse Practitioner	F3011071	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780671446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN BRIDGET FLYNN RICHARDS NP

Provider Business Mailing Address
First Line	:	2539 MIDDLE COUNTRY RD
Second Line	:	SUITE 4
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3551
Country	:	US
Telephone Number	:	631-737-6434
Fax Number	:	631-738-1226

Provider Business Practice Location Address
First Line	:	2539 MIDDLE COUNTRY RD
Second Line	:	SUITE 4
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3551
Country	:	US
Telephone Number	:	631-737-6434
Fax Number	:	631-738-1226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2005
Last Update Date	:	04/01/2008

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