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NPI Code Detail

MEDICARE: MRS. HOLLY A FITZGERALD PT

MEDICARE: MRS. HOLLY A FITZGERALD PT
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
1225100000XPhysical Therapist11329MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y61089OTHERMABLUE CROSS BLUE SHEILD
27016433OTHERMAAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4806155OTHERMATUFTS HEALTH PLAN
5617587OTHERMAHARVARD PILGRIM

General Provider Information

NPI Number : 1396744900
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY A FITZGERALD PT
Provider Business Mailing Address
First Line : 2 WASHINGTON ST
Second Line :
City : MELROSE
State : MA
Zip : 02176-6055
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 WASHINGTON ST
Second Line :
City : MELROSE
State : MA
Zip : 02176-6055
Country : US
Telephone Number : 781-321-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 01/30/2024

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Directions to “ MRS. HOLLY A FITZGERALD PT” Practice Location

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