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General NPI Number Information
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NPI Number | 1316822042
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Entity Type | Individual
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Provider Name | RAYCHEL NICOLE FITZGERALD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 450 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1118
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Country | US
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Telephone | 516-734-8000
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Fax | 516-941-1272
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Provider Business Mailing Address
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Address Line | 286 JERUSALEM AVE
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City | MASSAPEQUA
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State | NY
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Zip | 11758-3312
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Country | US
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Telephone | 516-270-6995
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 357542
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License Number State | NY
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