Provider Demographics
NPI:1700084662
Name:FINNEGAN, JUSTIN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:FINNEGAN
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WHITE OAKS LN
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3728
Mailing Address - Country:US
Mailing Address - Phone:845-255-4388
Mailing Address - Fax:
Practice Address - Street 1:5 WHITE OAKS LN
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3728
Practice Address - Country:US
Practice Address - Phone:845-255-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist