Individual
KATHLEEN M FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD17475
OR
2084N0400X
Neurology Physician
Primary
MD17475
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033345
—
OR
01
—
085564000
BLUE CROSS
OR
01
—
2329
LIPA
OR
01
—
P00429041
RAILROAD MEDICARE
OR
Enumeration date
04/04/2006
Last updated
11/17/2011
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