Healthcare Provider Details

I. General information

NPI: 1982524146
Provider Name (Legal Business Name): ABIGAIL R FITZGERALD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 STATE ROUTE 31 STE 104
CICERO NY
13039-8726
US

IV. Provider business mailing address

6221 STATE ROUTE 31 STE 104
CICERO NY
13039-8726
US

V. Phone/Fax

Practice location:
  • Phone: 315-698-4888
  • Fax:
Mailing address:
  • Phone: 315-698-4888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF35995401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: