Tammy M Flaherty

Individual provider Active NPI Licensed Practical Nurse · Herkimer, NY

NPI 1932419785 · NPPES record last updated Oct 18, 2010

Key facts

NPI
1932419785
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
621502-1 (NY)
Practice address
703 Middleville Rd RT 28
Herkimer, NY 13350-0107
Phone
(315) 866-7932
Fax
(315) 866-1814
NPI assigned
Oct 14, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
621502-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 621502-1 NY Yes

Addresses

Primary practice location

703 Middleville Rd RT 28
Herkimer, NY 13350-0107

Mailing address

PO Box 107
Herkimer, NY 13350-0107
Phone (315) 866-7932

Other identifiers

IdentifierTypeStateIssuer
01223385MedicaidNY

Other providers in Herkimer, NY

All providers in Herkimer, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.