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General NPI Number Information
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NPI Number | 1588145916
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH FITZGERALD CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 80 MONROE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-2405
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Country | US
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Telephone | 718-447-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 245 E 40TH ST APT 14F
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City | NEW YORK
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State | NY
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Zip | 10016-1715
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Country | US
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Telephone | 717-823-0388
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 14158230
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License Number State |
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