Provider Demographics
NPI:1619935152
Name:FINAZZO, JOSEPHINE JOANN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:JOANN
Last Name:FINAZZO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JOSEPHINE
Other - Middle Name:JOANN
Other - Last Name:FINAZZO-KAISER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:111 N MAPLEMERE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3178
Mailing Address - Country:US
Mailing Address - Phone:716-836-4646
Mailing Address - Fax:
Practice Address - Street 1:111 N MAPLEMERE RD STE 120
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3178
Practice Address - Country:US
Practice Address - Phone:716-836-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010120862085R0202X
NY3042172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11-4380543Medicaid
MI505968OtherCARE CHOICES
MIRA820037OtherM-CARE
MI11-4799592Medicaid
MI300H218760OtherBCBS
NY06831887Medicaid
MI3158213054OtherBCBS
MI3158213054OtherBCBS
MI0N063450Medicare ID - Type Unspecified