Individual
COUTNEY FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
39 TODD DR E, GLEN HEAD, NY 11545-1426
(516) 676-1930
Mailing address
39 TODD DR E, GLEN HEAD, NY 11545-1426
(516) 676-1930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
827753981
NY
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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