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General NPI Number Information
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NPI Number | 1891908182
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Entity Type | Individual
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Provider Name | KATE ELIZABETH FITZGERALD PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 150 NEW PROVIDENCE RD
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2590
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Country | US
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Telephone | 908-380-9861
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Fax |
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Provider Business Mailing Address
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Address Line | 705 CENTRAL AVE
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City | RAHWAY
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State | NJ
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Zip | 07065-2703
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Country | US
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Telephone |
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 40QA01237000
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License Number State | NJ
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