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General NPI Number Information
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NPI Number | 1861143232
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Entity Type | Individual
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Provider Name | NEETHU FITZSIMMONS
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Gender | Female
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 75 SEMINARY HILL RD
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City | CARMEL
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State | NY
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Zip | 10512-1921
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Country | US
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Telephone | 845-225-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 20 BRENTWOOD CIR
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City | DANBURY
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State | CT
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Zip | 06810-1518
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Country | US
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Telephone | 845-664-4278
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | F34746001
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License Number State | NY
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