Healthcare Provider Details

I. General information

NPI: 1801033246
Provider Name (Legal Business Name): DONNA JEAN FINCK PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RAPP RD
ALBANY NY
12203-4491
US

IV. Provider business mailing address

131 SOUTHERS RD
HUDSON NY
12534-3237
US

V. Phone/Fax

Practice location:
  • Phone: 518-867-3061
  • Fax:
Mailing address:
  • Phone: 518-828-7823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number004955-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: