Provider Demographics
NPI:1639622111
Name:FITZPATRICK, ALYSE MARIE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:ALYSE
Middle Name:MARIE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5858 SPRINGBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2809
Mailing Address - Country:US
Mailing Address - Phone:937-291-8910
Mailing Address - Fax:
Practice Address - Street 1:5858 SPRINGBORO PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45449-2809
Practice Address - Country:US
Practice Address - Phone:937-291-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03135449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist