MEDICARE: AMY FITZSIMMONS MD

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	208100000X	Physical Medicine & Rehabilitation Physician	MD045677L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DF3318	OTHER	PA	TRAVELERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992790927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY FITZSIMMONS MD

Provider Business Mailing Address
First Line	:	44 SECOND STREET PIKE
Second Line	:
City	:	SOUTHAMPTON
State	:	PA
Zip	:	18966-3830
Country	:	US
Telephone Number	:	215-322-7550
Fax Number	:	215-322-7117

Provider Business Practice Location Address
First Line	:	44 SECOND STREET PIKE
Second Line	:
City	:	SOUTHAMPTON
State	:	PA
Zip	:	18966-3830
Country	:	US
Telephone Number	:	215-322-7550
Fax Number	:	215-322-7117

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	09/20/2011

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Directions to “ AMY FITZSIMMONS MD” Practice Location

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