Healthcare Provider Details

I. General information

NPI: 1447309158
Provider Name (Legal Business Name): MEGAN S. FLYNN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N CENTRAL AVE SUITE 240
HARTSDALE NY
10530-1903
US

IV. Provider business mailing address

91 WOODS BROOKE LANE
YORKTOWN HEIGHTS NY
10598
US

V. Phone/Fax

Practice location:
  • Phone: 914-962-5593
  • Fax: 914-962-5599
Mailing address:
  • Phone: 914-962-5593
  • Fax: 914-962-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number012078-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: