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Individual

KEVIN PETER FITZMARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467
(718) 920-4316
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4316

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
068053
CO
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
125069783
IL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
292670
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/11/2013
Last updated
05/27/2022
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