Basic Information
Provider Information
NPI: 1790930113
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINKELSTEIN
FirstName: JONATHAN
MiddleName: ADAM
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11350 MCCORMICK RD
Address2: EXECUTIVE PLAZA 1, STE. 501
City: HUNT VALLEY
State: MD
PostalCode: 21031
CountryCode: US
TelephoneNumber: 7039148000
FaxNumber:  
Practice Location
Address1: 500 W MAIN ST
Address2: SUITE 116
City: BABYLON
State: NY
PostalCode: 117023027
CountryCode: US
TelephoneNumber: 6314226166
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/26/2008
LastUpdateDate: 06/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X263062NYN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X263062NYN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
208VP0014X263062NYY Allopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine

No ID Information.


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