Healthcare Provider Details

I. General information

NPI: 1164195574
Provider Name (Legal Business Name): ELIZABETH FITZPATRICK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 38TH ST FL 4
NEW YORK NY
10016-2772
US

IV. Provider business mailing address

25 HENRY W DUBOIS DR APT 45
NEW PALTZ NY
12561-1549
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7000
  • Fax:
Mailing address:
  • Phone: 845-674-3504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF-309958-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: