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Individual
TIMOTHY FLAHERTY
Active
Individual
TIMOTHY FLAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
J10002270
DE
225100000X
Physical Therapist
Primary
PT014202L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11795711
CAQH
—
01
—
1308253
PABS
—
01
—
1982892949
CHAMPUS TRICARE
—
05
—
1982892949
—
DE
01
—
2001620000
IBC
—
01
—
5070-0088
NCA
—
01
—
92832901
CAREFIRST
—
Enumeration date
10/04/2007
Last updated
03/12/2015
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