Healthcare Provider Details

I. General information

NPI: 1871985580
Provider Name (Legal Business Name): DAVID J FINITSIS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 RETREAT AVENUE HARTFORD HOSPITAL CANCER CENTER
HARTFORD CT
06106
US

IV. Provider business mailing address

85 RETREAT AVENUE HARTFORD HOSPITAL CANCER CENTER
HARTFORD CT
06106-2555
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-3127
  • Fax:
Mailing address:
  • Phone: 860-972-3127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number003737
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: