Provider Demographics
NPI:1467517250
Name:FITZGIBBONS, LISA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:M
Last Name:FITZGIBBONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-521-3230
Mailing Address - Fax:978-521-3256
Practice Address - Street 1:1 PARKWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-521-3230
Practice Address - Fax:978-521-3256
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH11591208000000X
MA203800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics