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General NPI Number Information
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NPI Number | 1053190884
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Entity Type | Individual
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Provider Name | CAITLIN COLLEEN FLYNN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 350 ENGLE ST FL 4
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-1808
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Country | US
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Telephone | 201-568-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 16 BARBARA RD
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City | DUMONT
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State | NJ
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Zip | 07628-1402
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Country | US
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Telephone | 908-442-2704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ14907900
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License Number State | NJ
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