Provider Demographics
NPI:1043367774
Name:FITZPATRICK, ANNE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6626
Mailing Address - Country:US
Mailing Address - Phone:718-983-7701
Mailing Address - Fax:718-983-7009
Practice Address - Street 1:2156 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6626
Practice Address - Country:US
Practice Address - Phone:718-983-7701
Practice Address - Fax:718-983-7009
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007425-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP641004OtherOXFORD
NY4511275OtherAETNA PPO
NY5803072OtherGHI
NY600236OtherACN
NY0489726OtherAETNA HMO
NYCO7425-4OtherWORKERS COMPENSATION
NYX1006OtherEMPIRE BLUE CROSS BLUE SH
NY4511275OtherAETNA PPO
NYU57178Medicare UPIN