Healthcare Provider Details

I. General information

NPI: 1730367855
Provider Name (Legal Business Name): NOREEN C FLYNN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 BLONDELL AVE
BRONX NY
10461-2660
US

IV. Provider business mailing address

8 HOVENKAMP AVE
NANUET NY
10954-3322
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8371
  • Fax: 718-405-8253
Mailing address:
  • Phone: 845-623-3562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number334810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: