MEDICARE: DEAN FITZGERALD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1265396907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEAN FITZGERALD

Provider Business Mailing Address
First Line	:	211 WISCASSET RD
Second Line	:
City	:	HIGHLAND LAKES
State	:	NJ
Zip	:	07422-9102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 WISCASSET RD
Second Line	:
City	:	HIGHLAND LAKES
State	:	NJ
Zip	:	07422-9102
Country	:	US
Telephone Number	:	973-568-6399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ DEAN FITZGERALD ” Practice Location

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