Provider Demographics
NPI:1023637535
Name:FINOTELLI JUNIOR, ITOR (PHD)
Entity type:Individual
Prefix:
First Name:ITOR
Middle Name:
Last Name:FINOTELLI JUNIOR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S 2ND ST STE 180
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-5000
Mailing Address - Country:US
Mailing Address - Phone:612-704-5925
Mailing Address - Fax:
Practice Address - Street 1:1300 S 2ND ST STE 180
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-5000
Practice Address - Country:US
Practice Address - Phone:612-704-5925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program