Provider Demographics
NPI:1598365579
Name:FITZPATRICK, EMILY ROSE (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 42ND RD APT 12B
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4137
Mailing Address - Country:US
Mailing Address - Phone:973-985-5094
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE # HCC12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:866-838-5864
Practice Address - Fax:929-455-9045
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF431804363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care