MEDICARE: STELLA CHAN-FLYNN CNM

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	207V00000X	Obstetrics & Gynecology Physician	186101	MA

General Provider Information

NPI Number	:	1801872270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STELLA CHAN-FLYNN CNM

Provider Business Mailing Address
First Line	:	91 E CONCORD ST
Second Line	:	MAT 4
City	:	BOSTON
State	:	MA
Zip	:	02118-2644
Country	:	US
Telephone Number	:	617-414-5469
Fax Number	:	617-414-5686

Provider Business Practice Location Address
First Line	:	91 E CONCORD ST
Second Line	:	MAT 4
City	:	BOSTON
State	:	MA
Zip	:	02118-2644
Country	:	US
Telephone Number	:	617-414-5469
Fax Number	:	617-414-5686

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	07/08/2007

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