Provider Demographics
NPI:1922312909
Name:FITZSIMMONS, BARBARA B
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:B
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:B
Other - Last Name:MAXFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:331 SEELEY RD
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-9236
Mailing Address - Country:US
Mailing Address - Phone:607-562-8095
Mailing Address - Fax:
Practice Address - Street 1:331 SEELEY RD
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-9236
Practice Address - Country:US
Practice Address - Phone:607-562-8095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002928-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002928-1OtherNY STATE OT LISCENCSE NUMBER