Healthcare Provider Details

I. General information

NPI: 1457268872
Provider Name (Legal Business Name): CASEY C FLYNN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 RICHMOND AVE
STATEN ISLAND NY
10314-1530
US

IV. Provider business mailing address

2201 BEVERLEY RD APT 623A
BROOKLYN NY
11226-8957
US

V. Phone/Fax

Practice location:
  • Phone: 718-499-0957
  • Fax:
Mailing address:
  • Phone: 443-924-1085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number055972
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: