Provider Demographics
NPI:1619973492
Name:FINKELSTEIN, RICHARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:FINKELSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1321 RODMAN ST
Mailing Address - Street 2:APT 2C
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1011
Mailing Address - Country:US
Mailing Address - Phone:215-893-4811
Mailing Address - Fax:215-893-4810
Practice Address - Street 1:309 S 13TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5917
Practice Address - Country:US
Practice Address - Phone:215-893-4811
Practice Address - Fax:215-893-4810
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD014516E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005976600008Medicaid
PAC29417Medicare UPIN
PA0005976600008Medicaid