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General NPI Number Information
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NPI Number | 1538473731
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Entity Type | Individual
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Provider Name | CAROLYN MARY FLAHERTY RN
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Gender | Female
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 31 SEQUAMS LANE
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City | W. ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 631-669-8377
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Fax |
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Provider Business Mailing Address
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Address Line | 31 SEQUAMS LANE
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City | W. ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 631-669-8377
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402764
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 22568176
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 305943
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License Number State | NY
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