Basic Information
| Provider Information | |||||||||
| NPI: | 1841209582 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINK | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 IRVING ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200102921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015818078 | ||||||||
| FaxNumber: | 3015818031 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 IRVING ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200102921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015818078 | ||||||||
| FaxNumber: | 3015818031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 12/11/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD30500 | DC | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 994923 | 01 | AETNA HMO | OTHER | DCA0030500 | 01 | BC NCA | OTHER | 547277-02 | 01 | BS OF MD | OTHER | 114428 | 01 | KAISER | OTHER | 5460-0071 | 01 | BS NCA | OTHER | 255787 | 01 | MAMSI | OTHER | 9051803002 | 01 | CIGNA | OTHER | 5421585 | 01 | AETNA NON-HMO | OTHER |