Provider Demographics
NPI:1255130522
Name:FINNEYFROCK, LILY MAE (CSFA)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:MAE
Last Name:FINNEYFROCK
Suffix:
Gender:
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 GETTYS ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2534
Mailing Address - Country:US
Mailing Address - Phone:301-473-6610
Mailing Address - Fax:
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:301-473-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD212647208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery