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General NPI Number Information
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NPI Number | 1306356191
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Entity Type | Individual
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Provider Name | JANICE C FLYNN
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Gender | Female
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 79 STONINGTON RD
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City | MYSTIC
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State | CT
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Zip | 06355-2931
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Country | US
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Telephone | 860-536-5835
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Fax | 860-536-5837
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Provider Business Mailing Address
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Address Line | 7 SOUND BREEZE AVE
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City | GROTON
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State | CT
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Zip | 06340-8846
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Country | US
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Telephone | 413-627-7684
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH19257
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS57124
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0006175
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License Number State | CT
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