Provider Demographics
NPI:1255502480
Name:FINKELSTEIN, MARK (MA, PD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:FINKELSTEIN
Suffix:
Gender:M
Credentials:MA, PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12071 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8010
Mailing Address - Country:US
Mailing Address - Phone:954-344-3797
Mailing Address - Fax:954-345-6829
Practice Address - Street 1:12071 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8010
Practice Address - Country:US
Practice Address - Phone:954-344-3797
Practice Address - Fax:954-345-6829
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-16
Last Update Date:2008-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISS432103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool