Provider Demographics
NPI:1306036678
Name:MARTHA B. FINN MD NEPHROLOGY PC
Entity Type:Organization
Organization Name:MARTHA B. FINN MD NEPHROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PYSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-326-0312
Mailing Address - Street 1:1660 SYCAMORE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-9314
Mailing Address - Country:US
Mailing Address - Phone:570-326-0312
Mailing Address - Fax:570-326-2643
Practice Address - Street 1:1660 SYCAMORE RD
Practice Address - Street 2:SUITE C
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-9314
Practice Address - Country:US
Practice Address - Phone:570-326-0312
Practice Address - Fax:570-326-2643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014795E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017924530002Medicaid
PA0017924530002Medicaid