Basic Information
Provider Information | |||||||||
NPI: | 1528017829 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FINCH | ||||||||
FirstName: | MATURIN | ||||||||
MiddleName: | D | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 2200 | ||||||||
Address2: |   | ||||||||
City: | AMHERST | ||||||||
State: | NH | ||||||||
PostalCode: | 030314200 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6036739411 | ||||||||
FaxNumber: | 6036739899 | ||||||||
Practice Location | |||||||||
Address1: | 2 REHABILITATION WAY | ||||||||
Address2: |   | ||||||||
City: | WOBURN | ||||||||
State: | MA | ||||||||
PostalCode: | 018016003 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7819355050 | ||||||||
FaxNumber: | 7819328152 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/06/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 60067 | MA | Y |   | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |   |
ID Information
ID | Type | State | Issuer | Description | 0015590 | 01 | MA | NEIGHBORHOOD HEALTH | OTHER | 134320 | 01 | NH | HEALTHSOURCE | OTHER | 724361 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 80184 | 01 | MA | HARVARD PILGRIM | OTHER | 114766 | 01 | MA | AETNA | OTHER | 3096441 | 05 | MA |   | MEDICAID | J12854 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER |