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NPI Code Detail

MEDICARE: COURTNEY FITZGERALD SLP

MEDICARE: COURTNEY FITZGERALD SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist016951NY

General Provider Information

NPI Number : 1427279371
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY FITZGERALD SLP
Provider Business Mailing Address
First Line : 1372 1ST AVE
Second Line : 4D
City : NEW YORK
State : NY
Zip : 10021-3810
Country : US
Telephone Number : 917-684-9404
Fax Number :
Provider Business Practice Location Address
First Line : 833 65TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4737
Country : US
Telephone Number : 718-283-8961
Fax Number : 718-283-8961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 10/14/2009

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Directions to “ COURTNEY FITZGERALD SLP” Practice Location

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