Individual
VINCENT JOHN FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
155 CHESTNUT ST, NUTLEY, NJ 07110-2311
(973) 667-1184
Mailing address
290 SIP AVE, JERSEY CITY, NJ 07306-6511
(201) 400-9156
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05372900
NJ
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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