Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-42314 | NY |
NPI | 1124398300 |
---|---|
Provider Name | Mrs. Melissa Anne Flynn |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2012 |
Last Update Date | 23/10/2013 |