Provider Demographics
NPI:1225029895
Name:FINN, KATHLEEN MARY (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARY
Last Name:FINN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:MARY
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:936 QUADDICK TOWN FARM RD
Mailing Address - Street 2:
Mailing Address - City:THOMPSON
Mailing Address - State:CT
Mailing Address - Zip Code:06277-2518
Mailing Address - Country:US
Mailing Address - Phone:860-315-7432
Mailing Address - Fax:
Practice Address - Street 1:100 SOUTH ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-4051
Practice Address - Country:US
Practice Address - Phone:508-765-9771
Practice Address - Fax:508-764-2448
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227015207P00000X
CT358207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1259095Medicaid
MAA40071Medicare PIN
CTFO1400Medicare UPIN
CT1259095Medicaid