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General NPI Number Information
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NPI Number | 1114654191
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Entity Type | Individual
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Provider Name | ROBERT FLANNERY PA-S
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Gender | Male
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 8 PINE ST
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City | ASHLAND
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State | PA
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Zip | 17921-9585
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Country | US
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Telephone | 570-590-0445
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Fax |
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Provider Business Mailing Address
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Address Line | 1089 W ASHLAND AVE
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City | GLENOLDEN
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State | PA
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Zip | 19036-1125
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Country | US
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Telephone |
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Fax | 701-732-2501
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA064089P
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License Number State | PA
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