Provider Demographics
NPI:1508017294
Name:FITZPATRICK, JAMES DONOVAN JR (LAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DONOVAN
Last Name:FITZPATRICK
Suffix:JR
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LAFAYETTE STREET
Mailing Address - Street 2:UNIVERSITY OF BRIDGEPORT
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604
Mailing Address - Country:US
Mailing Address - Phone:203-576-4302
Mailing Address - Fax:
Practice Address - Street 1:60 LAFAYETTE STREET
Practice Address - Street 2:UNIVERSITY OF BRIDGEPORT
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604
Practice Address - Country:US
Practice Address - Phone:203-576-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist