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General NPI Number Information
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NPI Number | 1235819962
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Entity Type | Individual
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Provider Name | CASEY FITZSIMONS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 320 WAVERLY AVE
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City | EAST ROCKAWAY
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State | NY
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Zip | 11518-2118
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Country | US
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Telephone | 516-887-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 2677 ISLAND CHANNEL RD
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City | SEAFORD
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State | NY
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Zip | 11783-3322
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Country | US
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Telephone | 516-587-3842
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 023966
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License Number State | NY
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