Active NPI
Alicia Francine Flynn, CDN
- Nutritionist
- Bronx, NY
National Provider Identifier
1366742504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 003603-1
- Practice address
- 1276 Fulton Ave
3Rd FLR
Bronx, NY 10456-3402 - Phone
- (718) 901-6280
- NPI assigned
- Oct 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 003603-1 | NY | Primary |
Addresses
Primary practice location
1276 Fulton Ave
3Rd FLR
Bronx, NY 10456-3402
Mailing address
525 W 156TH St
2E
New York, NY 10032-7754
Phone (917) 405-1837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003603 | NY | MD | Contractor |
| 003603-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287619200000",
"number": "1366742504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 W 156TH ST",
"address_2": "2E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100327754",
"telephone_number": "917-405-1837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1276 FULTON AVE",
"address_2": "3RD FLR",
"city": "BRONX",
"state": "NY",
"postal_code": "104563402",
"telephone_number": "718-901-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "ALICIA",
"middle_name": "FRANCINE",
"name_prefix": "Ms.",
"credential": "CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-21",
"last_updated": "2010-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NY",
"license": "003603-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.