Individual
MS. PAULA FITZSIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1020 CRAFT RD STE C, ITHACA, NY 14850-1016
(607) 339-0625
(607) 535-2714
Mailing address
1020 CRAFT RD STE C, ITHACA, NY 14850-1016
(607) 339-0625
(607) 535-2714
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002880-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02966461
—
NY
Enumeration date
01/30/2007
Last updated
01/02/2019
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