Provider Demographics
NPI:1013954429
Name:FINAN-DUFFY, COLLEEN M (DO)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:M
Last Name:FINAN-DUFFY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 KRESSON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3227
Mailing Address - Country:US
Mailing Address - Phone:856-616-2444
Mailing Address - Fax:856-616-2376
Practice Address - Street 1:36 KRESSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3227
Practice Address - Country:US
Practice Address - Phone:856-616-2444
Practice Address - Fax:856-616-2376
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB63508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7274009Medicaid
908839PT2Medicare ID - Type Unspecified
NJ7274009Medicaid