Provider Demographics
NPI:1568722502
Name:FINOCCHIARO, ANDREA (DO)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:FINOCCHIARO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 SENECA TPKE
Mailing Address - Street 2:CROSSROADS PLAZA
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-4912
Mailing Address - Country:US
Mailing Address - Phone:315-624-8500
Mailing Address - Fax:315-624-8515
Practice Address - Street 1:8411 SENECA TPKE
Practice Address - Street 2:CROSSROADS PLAZA
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-4912
Practice Address - Country:US
Practice Address - Phone:315-624-8500
Practice Address - Fax:315-624-8515
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04171968Medicaid
NYJ400234978Medicare UPIN