Individual
DENISE FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-6227
(860) 679-3540
(860) 679-1390
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
000108
CT
Other
Enumeration date
09/01/2006
Last updated
09/26/2022
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