Individual
KERRY FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
94 BROADWAY, MASSAPEQUA PARK, NY 11762-2527
(516) 798-8413
Mailing address
94 BROADWAY, MASSAPEQUA PARK, NY 11762-2527
(516) 798-8413
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
008543-1
NY
Other
Enumeration date
11/12/2012
Last updated
11/12/2012
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