Provider Demographics
NPI:1538504253
Name:SAVINO FITZGERALD, LISA ANNE (FNP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANNE
Last Name:SAVINO FITZGERALD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 BRIXTON RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1324
Mailing Address - Country:US
Mailing Address - Phone:516-739-5166
Mailing Address - Fax:516-873-6677
Practice Address - Street 1:174 BRIXTON RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1324
Practice Address - Country:US
Practice Address - Phone:516-739-5166
Practice Address - Fax:516-873-6677
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily