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General NPI Number Information
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NPI Number | 1831176148
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Entity Type | Individual
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Provider Name | JOHN KEVIN FITZPATRICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 45 READE PL
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601-3947
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Country | US
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Telephone | 716-601-5419
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Fax |
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Provider Business Mailing Address
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Address Line | 64 GRANDVIEW ACRES RD
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City | PHOENICIA
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State | NY
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Zip | 12464-5301
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Country | US
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Telephone | 716-601-5419
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 80278
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 242431
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 206765
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License Number State | NY
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