Provider Demographics
NPI:1568070167
Name:FITZPATRICK, ERIN (MS, RDN, CDN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1707
Mailing Address - Country:US
Mailing Address - Phone:516-426-4272
Mailing Address - Fax:
Practice Address - Street 1:445 JACKSON ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1707
Practice Address - Country:US
Practice Address - Phone:516-426-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009366-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered