Provider Demographics
NPI:1053596122
Name:FINCH, TANYA J (FNP-BC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:J
Last Name:FINCH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:J
Other - Last Name:QUARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS FNP
Mailing Address - Street 1:9 CAREY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-7880
Mailing Address - Country:US
Mailing Address - Phone:518-761-0300
Mailing Address - Fax:518-824-2388
Practice Address - Street 1:11 CROSS ST
Practice Address - Street 2:
Practice Address - City:BOLTON LANDING
Practice Address - State:NY
Practice Address - Zip Code:12814-0539
Practice Address - Country:US
Practice Address - Phone:518-644-9471
Practice Address - Fax:518-644-2915
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF320075363LF0000X, 363LC1500X
NY320075363LF0000X
NJ26NJ000804000363LC1500X
MARN2312958363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02957197Medicaid
MAMQ1651808OtherDEA
NYMF4754594OtherDEA
NY1053596122OtherNPI
DEMF4799625OtherDEA