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General NPI Number Information
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NPI Number | 1831686013
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Entity Type | Individual
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Provider Name | KAYLA MARIE FLYNN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 100 HIGH ST FL 3
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City | BUFFALO
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State | NY
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Zip | 14203-1126
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Country | US
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Telephone | 716-710-8266
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 488
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City | BUFFALO
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State | NY
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Zip | 14240-0488
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Country | US
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Telephone | 716-852-4772
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110006224
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License Number State | VA
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