Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 0250751 | NY |
N | 225100000X | Physical Therapist | HOQA01273800 | NJ |
N | 2251N0400X | Physical Therapist - Neurology | 0250751 | NY |
N | 2251P0200X | Physical Therapist - Pediatrics | 0250751 | NY |
N | 2251S0007X | Physical Therapist - Sports | 0250751 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 0250751 | NY |
NPI | 1306984075 |
---|---|
Provider Name | Mr. Ryan Thomas Finucane |
First Address | Fairview, NJ 07022-1300 |
Second Address | Fairview, NJ 07022-1300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 16/04/2008 |