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General NPI Number Information
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NPI Number | 1578723011
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Entity Type | Individual
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Provider Name | ANDREW MICHAEL FLANAGAN DO
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 101 HOSPITAL RD
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4870
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Country | US
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Telephone | 631-654-7763
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Fax |
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Provider Business Mailing Address
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Address Line | 5 WILLIAMS BOULEVARD APT 2P
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City | LAKE GROVE
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State | NY
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Zip | 11755
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Country | US
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Telephone | 631-585-5829
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 258009
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License Number State | NY
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