Healthcare Provider Details

I. General information

NPI: 1922243203
Provider Name (Legal Business Name): ROSEMARY FLYNN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 GILBERT AVE
PEARL RIVER NY
10965-3319
US

IV. Provider business mailing address

647 GILBERT AVE
PEARL RIVER NY
10965-3319
US

V. Phone/Fax

Practice location:
  • Phone: 845-735-4356
  • Fax:
Mailing address:
  • Phone: 845-735-4356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number016932-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: