Healthcare Provider Details

I. General information

NPI: 1689590655
Provider Name (Legal Business Name): COLE FITZPATRICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MEIGS AVE
MADISON CT
06443-3057
US

IV. Provider business mailing address

9 WHITE OAK FARM RD
NEWTOWN CT
06470-2501
US

V. Phone/Fax

Practice location:
  • Phone: 203-245-8217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2396
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: