MEDICARE: MRS. LINDA L FLAHERTY

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	152W00000X	Optometrist	6000000997	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902895956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA L FLAHERTY

Provider Business Mailing Address
First Line	:	3402 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3205
Country	:	US
Telephone Number	:	412-621-6027
Fax Number	:	412-621-4047

Provider Business Practice Location Address
First Line	:	3402 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3205
Country	:	US
Telephone Number	:	412-621-6027
Fax Number	:	412-621-4047

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/09/2007

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