MEDICARE: GLEN RAYMOND FINNEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME93383	FL
2	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	MD454885	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447206107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLEN RAYMOND FINNEY MD

Provider Business Mailing Address
First Line	:	100 NORTH ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17852-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:	570-271-6578

Provider Business Practice Location Address
First Line	:	1000 EAST MOUNTAIN BLVD
Second Line	:
City	:	WILKES BARRE
State	:	PA
Zip	:	18711-3731
Country	:	US
Telephone Number	:	570-808-6026
Fax Number	:	570-808-3208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	08/28/2020

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Directions to “ GLEN RAYMOND FINNEY MD” Practice Location

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