Healthcare Provider Details

I. General information

NPI: 1679786412
Provider Name (Legal Business Name): PATRICIA JEAN FRITZ R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 PARK ST
NEW HAVEN CT
06511
US

IV. Provider business mailing address

55 PARK ST
NEW HAVEN CT
06511-5474
US

V. Phone/Fax

Practice location:
  • Phone: 860-482-5384
  • Fax: 860-496-4952
Mailing address:
  • Phone: 860-482-5384
  • Fax: 860-496-4952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15045
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02744500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0006877
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number116939-3
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2909
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: