Individual
LILA MAE FLAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 643-8281
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-3830
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
CMD19213
RI
2084P0800X
Psychiatry Physician
308079
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NO OTHER IDENTIFIERS
—
Enumeration date
05/06/2019
Last updated
08/05/2024
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