Basic Information
| Provider Information | |||||||||
| NPI: | 1528162195 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FINIZIO - RADIOLOGY IMAGING ASSOCIATES, PC | ||||||||
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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: | 230 W DARES BEACH RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206783151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018559754 | ||||||||
| FaxNumber: | 3018551367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | FINIZIO | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | P. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR/RADIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 3018566718 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | N | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist | 174400000X | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 1606138 | 01 | MD | AMERICHOICE GROUP NUMBER | OTHER | 471857408/004 | 01 | MD | TRICARE GROUP NUMBER | OTHER | 172996 | 01 | MD | ANTHEM | OTHER | 2127917 | 01 | MD | ALLIANCE(MRI) | OTHER | 5100501 | 01 | MD | AETNA PPO | OTHER | 533549 | 01 | AETNA | OTHER | 1604829 | 01 | MD | UNITED HEALTH CARE | OTHER | 340CRA | 01 | MD | CAREFIRST GROUP NUMBER | OTHER | 407579003 | 05 | MD | MEDICAID | K945 | 01 | MD | NCA FEDERAL GROUP NUMBER | OTHER | 3127365 | 01 | MD | ALLIANCE(NON-MRI) | OTHER |