Healthcare Provider Details

I. General information

NPI: 1255561734
Provider Name (Legal Business Name): JUDITH ANN FINUCAN APN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 ROUTE 70 UNIT C3
MANCHESTER NJ
08759-5806
US

IV. Provider business mailing address

1043 ROUTE 70 UNIT C3
MANCHESTER NJ
08759-5806
US

V. Phone/Fax

Practice location:
  • Phone: 732-657-6100
  • Fax: 732-657-0111
Mailing address:
  • Phone: 732-657-6100
  • Fax: 732-657-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NN04721900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: