Individual
DR. JOHN M. FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
565 ABBOTT RD, BUFFALO, NY 14220-2039
(716) 828-2399
Mailing address
3040 AMSDELL RD, HAMBURG, NY 14075-5835
(716) 649-9000
(716) 649-9005
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
218039
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
218039
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027170405
UNIVERA HEALTHCARE
NY
01
—
000528130001
BCBS
NY
05
—
02648786
—
NY
01
—
050709000020
FIDELIS CARE OF NEW YORK
NY
01
—
1609206
INDEPENDENT HEALTH
NY
01
—
190443FF
PREFERRED CARE
NY
01
—
P00257184
RR MEDICARE
NY
Enumeration date
04/03/2006
Last updated
09/16/2013
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