Provider Demographics
NPI:1962192419
Name:SEASIDE PSYCHIATRIC PLLC
Entity type:Organization
Organization Name:SEASIDE PSYCHIATRIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:FINNERTY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:781-710-3767
Mailing Address - Street 1:3 CRESSWELL LN
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-2157
Mailing Address - Country:US
Mailing Address - Phone:781-710-3767
Mailing Address - Fax:
Practice Address - Street 1:3 CRESSWELL LN
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-2157
Practice Address - Country:US
Practice Address - Phone:781-710-3767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty