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General NPI Number Information
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NPI Number | 1629252317
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Entity Type | Organization
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Legal Business Name | CHERYL FLYNN MD INC
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 2 WAKE ROBIN RD SUITE 202
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City | LINCOLN
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State | RI
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Zip | 02865-4241
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Country | US
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Telephone | 401-333-1656
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Fax | 401-333-3104
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Provider Business Mailing Address
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Address Line | 2 WAKE ROBIN RD SUITE 202
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City | LINCOLN
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State | RI
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Zip | 02865-4241
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHERYL FLYNN
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Credential | MD PHD
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Telephone | 401-333-1656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 8251
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License Number State | RI
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