Healthcare Provider Details

I. General information

NPI: 1699858142
Provider Name (Legal Business Name): JEAN G. FITZPATRICK NCPSYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 TAVANO RD
OSSINING NY
10562-3105
US

IV. Provider business mailing address

7 TAVANO RD
OSSINING NY
10562-3105
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-6478
  • Fax:
Mailing address:
  • Phone: 914-941-6478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number000527
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: