=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861551145
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA FINK MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2006
-----------------------------------------------------
Last Update Date | 01/10/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 41 S BEDFORD RD
-----------------------------------------------------
City | MOUNT KISCO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10549-3407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-393-4127
-----------------------------------------------------
Fax | 914-763-0099
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 59 TRUESDALE LAKE DR
-----------------------------------------------------
City | SOUTH SALEM
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10590-1317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-393-4127
-----------------------------------------------------
Fax | 914-763-0099
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 040667
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 40667
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 179500-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------