Organization
EVERGREEN WOMEN'S HEALTH GROUP, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KEVIN FITZPATRICK MD (PARTNER)
(716) 712-0862
Entity
Organization
Contact information
Practice address
1026 UNION RD, WEST SENECA, NY 14224-3449
(716) 712-0862
Mailing address
1026 UNION RD, WEST SENECA, NY 14224-3449
(716) 712-0862
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02332823
—
NY
01
—
4785240002
DME MEDICARE
—
Enumeration date
05/01/2006
Last updated
10/03/2007
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