Provider Demographics
NPI:1578535324
Name:FITZPATRICK, PAMELA M (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:M
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 AUSTIN RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-4812
Mailing Address - Country:US
Mailing Address - Phone:845-208-3571
Mailing Address - Fax:845-225-5426
Practice Address - Street 1:95 GLENEIDA AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1222
Practice Address - Country:US
Practice Address - Phone:845-225-2749
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407585-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health