Provider Demographics
NPI:1285622423
Name:O'FLAHERTY, KEVIN PAUL (PHD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:PAUL
Last Name:O'FLAHERTY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 E 67TH ST
Mailing Address - Street 2:SUITE 4F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6119
Mailing Address - Country:US
Mailing Address - Phone:212-628-2710
Mailing Address - Fax:212-628-3580
Practice Address - Street 1:34 E 67TH ST
Practice Address - Street 2:SUITE 4F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6119
Practice Address - Country:US
Practice Address - Phone:212-628-2710
Practice Address - Fax:212-628-3580
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002641231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
133691938OtherUNITED HEALTHCARE
OK0264OtherATLANTIS POS
0264OtherHIP
MT000120OtherSELECT PRO
12033804OtherMULTIPLAN #P
4216513OtherAETNA USHC
7992734002OtherCIGNA
N5509OtherOXFORD
133691938002OtherHEALTHFIRST
206742OtherPHS
2C6742OtherGOAVARAN PHS
0096283OtherGHI
133691938OtherPROCARE
M00461OtherBCBS
206742OtherPHS