Provider Demographics
NPI:1821380262
Name:FINCH, VLADA E (MD)
Entity Type:Individual
Prefix:
First Name:VLADA
Middle Name:E
Last Name:FINCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-2221
Mailing Address - Country:US
Mailing Address - Phone:732-570-7055
Mailing Address - Fax:
Practice Address - Street 1:2624 HWY 516
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2306
Practice Address - Country:US
Practice Address - Phone:732-952-5000
Practice Address - Fax:732-952-5005
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116023295390200000X
NJ25MA09430700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207Q00000XOtherFAMILY MEDICINE