Provider Demographics
NPI:1306958442
Name:FINA, TERRENCE J (PA)
Entity type:Individual
Prefix:
First Name:TERRENCE
Middle Name:J
Last Name:FINA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:FINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 PARK ST
Mailing Address - Street 2:GLENS FALLS HOSPITAL
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-6992
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:100 PARK ST
Practice Address - Street 2:GLENS FALLS HOSPITAL
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4413
Practice Address - Country:US
Practice Address - Phone:518-926-3000
Practice Address - Fax:518-926-3127
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA737363A00000X
NY004980363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
R79346Medicare UPIN
MAAP0342Medicare ID - Type Unspecified