Healthcare Provider Details

I. General information

NPI: 1346553104
Provider Name (Legal Business Name): CATHERINE MARIE FLYNN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 FROEHLICH FARM BLVD
WOODBURY NY
11797-2906
US

IV. Provider business mailing address

173 FROEHLICH FARM BLVD
WOODBURY NY
11797-2906
US

V. Phone/Fax

Practice location:
  • Phone: 516-682-8288
  • Fax:
Mailing address:
  • Phone: 516-682-8288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002309
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: