Individual
JOHN KEVIN FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
45 READE PL, POUGHKEEPSIE, NY 12601-3947
(716) 601-5419
Mailing address
64 GRANDVIEW ACRES RD, PHOENICIA, NY 12464-5301
(716) 601-5419
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
206765
NY
207V00000X
Obstetrics & Gynecology Physician
242431
MA
207V00000X
Obstetrics & Gynecology Physician
80278
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010307607
UNIVERA
NY
01
—
00010307609
UNIVERA
NY
01
—
000525153009
BC/BS
NY
01
—
000525153011
BC/BS
NY
05
—
01775837
—
NY
01
—
040426000844
FIDELIS
NY
01
—
050407000022
FIDELIS
NY
01
—
0709873
IND. HEALTH
NY
01
—
111517CK
PREFERRED CARE
NY
01
—
452962
WELLCARE
NY
Enumeration date
12/28/2005
Last updated
07/02/2025
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