Healthcare Provider Details

I. General information

NPI: 1649205964
Provider Name (Legal Business Name): BERNADETTE ANN FITZPATRICK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 EAST 23RD STREET DEPARTMENT OF VETERANS AFFAIRS NEW YORK HARBOR HEALTH CARE SYSTEM - AUDIOLOGY
NEW YORK NY
10010
US

IV. Provider business mailing address

423 EAST 23RD STREET DEPARTMENT OF VETERANS AFFAIRS NEW YORK HARBOR HEALTH CARE SYSTEM - AUDIOLOGY
NEW YORK NY
10010
US

V. Phone/Fax

Practice location:
  • Phone: 212-686-7500
  • Fax:
Mailing address:
  • Phone: 212-686-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1091
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: