Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | PS003606L | PA |
NPI | 1548390040 |
---|---|
Provider Name | Dr. Thomas Eugene Fink |
First Address | Harrisburg, PA 17106-0747 |
Second Address | Harrisburg, PA 17112-9503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013914180004 | (05) | PA |
02306500 | CAPITAL BLUE CROSS (01) | PA |
AC1425050 | HIGHMARK (01) | PA |
R07086 | (02) | PA |