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General NPI Number Information
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NPI Number | 1235788092
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Entity Type | Individual
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Provider Name | MARY FITZGERALD SWITALA APN
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Gender | Female
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 401 HAMBURG TPKE
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City | WAYNE
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State | NJ
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Zip | 07470-2154
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Country | US
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Telephone | 973-432-7736
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BROWN RIDGE CT
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-1633
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Country | US
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Telephone | 973-432-7736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ00952200
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License Number State | NJ
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