Provider Demographics
NPI:1194536656
Name:FLAHERTY, DANIEL PATRICK (PA-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PATRICK
Last Name:FLAHERTY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MR
Other - First Name:DANNY
Other - Middle Name:PATRICK
Other - Last Name:FLAHERTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:10800 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-4200
Mailing Address - Country:US
Mailing Address - Phone:215-612-4000
Mailing Address - Fax:215-612-3313
Practice Address - Street 1:10800 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-4200
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-612-3313
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066451363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant