Provider Demographics
NPI:1619925278
Name:FINERTY, SUSAN M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:FINERTY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COTTON CIR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4658
Mailing Address - Country:US
Mailing Address - Phone:603-472-5738
Mailing Address - Fax:
Practice Address - Street 1:17 RIVERSIDE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1373
Practice Address - Country:US
Practice Address - Phone:603-883-8049
Practice Address - Fax:603-879-9329
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH340363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS24065Medicare UPIN
NHAP1214Medicare ID - Type Unspecified