Provider Demographics
NPI:1699858142
Name:FITZPATRICK, JEAN G (NCPSYA)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:G
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TAVANO RD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-3105
Mailing Address - Country:US
Mailing Address - Phone:914-941-6478
Mailing Address - Fax:
Practice Address - Street 1:7 TAVANO RD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-3105
Practice Address - Country:US
Practice Address - Phone:914-941-6478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000527102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst