Healthcare Provider Details

I. General information

NPI: 1134740962
Provider Name (Legal Business Name): BENJAMIN ARTHUR FLINN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FISHER RD UNIT 1
BERLIN VT
05602-8132
US

IV. Provider business mailing address

2209 GENESEE STREET BUSINESS OFFICE ROOM 315
UTICA NY
13501
US

V. Phone/Fax

Practice location:
  • Phone: 802-225-7000
  • Fax:
Mailing address:
  • Phone: 315-801-3282
  • Fax: 315-801-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number314304
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042-0017206
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: