Provider Demographics
NPI:1083695944
Name:FINNEGAN, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:FINNEGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 GUY PARK AVE
Mailing Address - Street 2:ATTN: CHRISTINE RUSSO
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1055
Mailing Address - Country:US
Mailing Address - Phone:518-841-7430
Mailing Address - Fax:
Practice Address - Street 1:425 GUY PARK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1043
Practice Address - Country:US
Practice Address - Phone:518-843-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038782207RG0100X
NY243548207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001387829Medicaid
NY02940605Medicaid
CT110009167Medicare ID - Type Unspecified
CTH19845Medicare UPIN
CT001387829Medicaid