Individual
KHADISHA FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4624 BROADWAY, NEW YORK, NY 10040-2102
(212) 569-1044
Mailing address
4624 BROADWAY, NEW YORK, NY 10040-2102
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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