Healthcare Provider Details

I. General information

NPI: 1710984125
Provider Name (Legal Business Name): MARK ALLEN FINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROUTE 347 BLDG 14A
STONY BROOK NY
11790-2554
US

IV. Provider business mailing address

2500 ROUTE 347 BLDG 14A
STONY BROOK NY
11790-2554
US

V. Phone/Fax

Practice location:
  • Phone: 631-689-7800
  • Fax: 631-689-3016
Mailing address:
  • Phone: 631-689-7800
  • Fax: 631-689-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number175861
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: