MEDICARE: MR. ROBERT FLYNN JR. MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1831557610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT FLYNN JR. MFT

Provider Business Mailing Address
First Line	:	139 ORANGE ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3140
Country	:	US
Telephone Number	:	203-937-2309
Fax Number	:	203-604-0542

Provider Business Practice Location Address
First Line	:	139 ORANGE ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3140
Country	:	US
Telephone Number	:	203-937-2309
Fax Number	:	203-604-0542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2016
Last Update Date	:	02/08/2016

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