Healthcare Provider Details

I. General information

NPI: 1659506756
Provider Name (Legal Business Name): JENNIFER FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 02/25/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

148 FIRENZE DR
OAKDALE PA
15071-1773
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-4305
  • Fax:
Mailing address:
  • Phone: 412-979-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006568L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: