Individual
ANDREA FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
46 GIANT OAK RD, RIDGE, NY 11961-2609
(631) 767-6935
Mailing address
46 GIANT OAK RD, RIDGE, NY 11961-2609
(631) 767-6935
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
602665-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602665-1
—
NY
Enumeration date
07/11/2008
Last updated
07/11/2008
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