Provider Demographics
NPI:1306984075
Name:FINUCANE, RYAN THOMAS (PT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:THOMAS
Last Name:FINUCANE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:222 BERGEN BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:07022-1300
Mailing Address - Country:US
Mailing Address - Phone:201-945-1156
Mailing Address - Fax:201-945-0012
Practice Address - Street 1:222 BERGEN BLVD STE 8
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NJ
Practice Address - Zip Code:07022-1300
Practice Address - Country:US
Practice Address - Phone:201-945-1156
Practice Address - Fax:201-945-0012
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJHOQA01273800225100000X
NY0250751225100000X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ122590RB9Medicare PIN