Provider Demographics
NPI:1801863691
Name:FITZPATRICK, PATRICIA G (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:G
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:30 HAGEN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2658
Mailing Address - Country:US
Mailing Address - Phone:585-338-2700
Mailing Address - Fax:585-242-9663
Practice Address - Street 1:30 HAGEN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2658
Practice Address - Country:US
Practice Address - Phone:585-338-2700
Practice Address - Fax:585-242-9663
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143633207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0001084044OtherUNITED HEALTHCARE
NY00833101Medicaid
6890OtherBCBS
POO10143633OtherEXCELLUS
301133OtherWELLCARE
005251451OtherHEALTH NOW (PARNALL)
4285979OtherAETNA
005251451OtherCOMM BLUE/BCBSWNY
060047207OtherRAILROAD MEDICARE
2197784OtherGHI
7701216OtherMVP
MDC187OtherPREFERRED CARE
PO10143633OtherGRIPA
RC60143633OtherRCIPA
000525145003OtherHEALTH NOW (LINDEN)
301133OtherWELLCARE
060047207OtherRAILROAD MEDICARE