Healthcare Provider Details

I. General information

NPI: 1962534834
Provider Name (Legal Business Name): HEATHER BINDER FLYNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 11/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631B NORTH STREET
PITTSFIELD MA
01201-4109
US

IV. Provider business mailing address

725 NORTH ST
PITTSFIELD MA
01201-4109
US

V. Phone/Fax

Practice location:
  • Phone: 413-499-2054
  • Fax: 413-445-9174
Mailing address:
  • Phone: 413-881-5427
  • Fax: 413-496-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number231047
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: