Provider Demographics
NPI:1558026559
Name:FINNEGAN, JAMES PATRICK
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:FINNEGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BRENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3449
Mailing Address - Country:US
Mailing Address - Phone:717-476-4168
Mailing Address - Fax:
Practice Address - Street 1:532 BALTIMORE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6118
Practice Address - Country:US
Practice Address - Phone:667-367-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX5492133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered