=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194368936
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICIA FLIHAN NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2019
-----------------------------------------------------
Last Update Date | 07/30/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7845 ROME WESTERNVILLE RD
-----------------------------------------------------
City | ROME
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13440-2202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-337-2500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7845 ROME WESTERNVILLE RD
-----------------------------------------------------
City | ROME
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13440-2202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-337-2500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | F09191285
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------