Healthcare Provider Details

I. General information

NPI: 1770593360
Provider Name (Legal Business Name): JOHN F FINKENSTADT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 IRVING AVE SUITE 402
SYRACUSE NY
13210-1756
US

IV. Provider business mailing address

475 IRVING AVE SUITE 402
SYRACUSE NY
13210-1756
US

V. Phone/Fax

Practice location:
  • Phone: 315-478-9710
  • Fax: 315-479-9145
Mailing address:
  • Phone: 315-478-9710
  • Fax: 315-479-9145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA1333509
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: