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General NPI Number Information
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NPI Number | 1851535801
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Entity Type | Organization
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Legal Business Name | FLAHERTY FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 1724 E RIDGE RD
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City | ROCHESTER
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State | NY
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Zip | 14622-2157
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Country | US
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Telephone | 585-467-7007
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Fax | 585-467-7012
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Provider Business Mailing Address
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Address Line | 1724 E RIDGE RD
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City | ROCHESTER
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State | NY
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Zip | 14622-2157
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Country | US
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Telephone | 585-467-7007
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Fax | 585-467-7012
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL J FLAHERTY
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Credential | D.O.
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Telephone | 585-467-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 196800
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License Number State | NY
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