MEDICARE: MR. SEAN JOSEPH FINNERTY CRNA

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	367500000X	Certified Registered Nurse Anesthetist	18573	OH

General Provider Information

NPI Number	:	1972969046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN JOSEPH FINNERTY CRNA

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2200
Country	:	US
Telephone Number	:	330-774-6142
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2200
Country	:	US
Telephone Number	:	330-774-6142
Fax Number	:

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

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	04/22/2017

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