Healthcare Provider Details

I. General information

NPI: 1568848596
Provider Name (Legal Business Name): KIRK ANTONIO FINLAY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST CHRISTINE EMMANUEL - SUITE 2A8
BRONX NY
10451-5504
US

IV. Provider business mailing address

234 E 149TH ST CHRISTINE EMMANUEL - SUITE 2A8
BRONX NY
10451-5504
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5692
  • Fax: 718-579-4781
Mailing address:
  • Phone: 718-579-5692
  • Fax: 718-579-4781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number059011
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: