Provider Demographics
NPI:1073798385
Name:FINOCCHIO, JUSTIN MATTHEW (RPH)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:MATTHEW
Last Name:FINOCCHIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11731-6207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1936 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:NY
Practice Address - Zip Code:11731-6207
Practice Address - Country:US
Practice Address - Phone:631-493-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist