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General NPI Number Information
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NPI Number | 1346318862
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Entity Type | Individual
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Provider Name | SUSAN ROSE FITZGERALD PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 1935 ROUTE 70 E
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2117
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Country | US
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Telephone | 856-546-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST # 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 856-356-4924
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | MA052827
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA052828
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00174000
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License Number State | NJ
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