Provider Demographics
NPI:1891279857
Name:FINI HEALTH AND WELLNESS GROUP, PLLC
Entity Type:Organization
Organization Name:FINI HEALTH AND WELLNESS GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEEMU
Authorized Official - Middle Name:
Authorized Official - Last Name:KERKULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-299-5569
Mailing Address - Street 1:5201 PENNELL RD STE A
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-6502
Mailing Address - Country:US
Mailing Address - Phone:877-346-4543
Mailing Address - Fax:
Practice Address - Street 1:5201 PENNELL RD STE A
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-6502
Practice Address - Country:US
Practice Address - Phone:877-346-4543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035816200001Medicaid
PA3790489001OtherKEYSTONE HEALTH PLAN EAST