Healthcare Provider Details

I. General information

NPI: 1447310966
Provider Name (Legal Business Name): MARIANNE FLANAGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 59TH ST FL 2 HIP MANHATTAN MENTAL HEALTH SERVICE
NEW YORK NY
10022-1475
US

IV. Provider business mailing address

9 STUYVESANT OVAL APT 8F
NEW YORK NY
10009-1913
US

V. Phone/Fax

Practice location:
  • Phone: 212-421-0473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number314067
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: