Healthcare Provider Details

I. General information

NPI: 1013194844
Provider Name (Legal Business Name): MICHAEL FINNEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL FINNEN PHARMACIST

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 SUNRISE HWY
HOLBROOK NY
11741-4801
US

IV. Provider business mailing address

45 JOSEPH ST
SAYVILLE NY
11782-1309
US

V. Phone/Fax

Practice location:
  • Phone: 631-218-8626
  • Fax:
Mailing address:
  • Phone: 631-244-5752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number035770
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: