Basic Information
Provider Information
NPI: 1700227774
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINI
FirstName: MARIA
MiddleName: ELIZABETH
NamePrefix: MISS
NameSuffix:  
Credential: BS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 35 PARK ST
Address2: APT. 1
City: BROOKLYN
State: NY
PostalCode: 112064540
CountryCode: US
TelephoneNumber: 7039899650
FaxNumber: 2018629136
Practice Location
Address1: 1086 TEANECK RD
Address2: SUITE 4A
City: TEANECK
State: NJ
PostalCode: 076664854
CountryCode: US
TelephoneNumber: 2018629900
FaxNumber: 2018629136
Other Information
ProviderEnumerationDate: 07/08/2013
LastUpdateDate: 07/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246ZE0600X NYY Technologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic

No ID Information.


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