Basic Information
| Provider Information | |||||||||
| NPI: | 1467566240 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FINIZIO - RADIOLOGY IMAGING ASSOICATES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7801 OLD BRANCH AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207351608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018566718 | ||||||||
| FaxNumber: | 3018566722 | ||||||||
| Practice Location | |||||||||
| Address1: | 8926 WOODYARD RD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207354220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018563670 | ||||||||
| FaxNumber: | 3018680129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | RICHARDSON | ||||||||
| AuthorizedOfficialFirstName: | RENEE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 3018566718 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 1606138 | 01 | MD | AMERICHOICE | OTHER | 3127365 | 01 | MD | ALLIANCE-MAMSI (NON-MRI) | OTHER | 5100501 | 01 | MD | AETNA PPO | OTHER | 125799 | 01 | MD | AETNA | OTHER | 471857408/005 | 01 | MD | TRICARE | OTHER | 407579001 | 05 | MD | MEDICAID | S351RA | 01 | MD | CAREFIRST GROUP NUMBER | OTHER | 1122 | 01 | MD | CAREFIRST FEDERAL | OTHER | 1606173 | 01 | MD | UNITED HEALTH CARE | OTHER | 172994 | 01 | MD | ANTHEM | OTHER |