Provider Demographics
NPI:1356792717
Name:FITZMAURICE, BRITTANY (NP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:FITZMAURICE
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 1:1 MUSTANG DR
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-4867
Mailing Address - Country:US
Mailing Address - Phone:518-881-1510
Mailing Address - Fax:518-785-1787
Practice Address - Street 1:1 MUSTANG DR
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-4867
Practice Address - Country:US
Practice Address - Phone:518-881-1510
Practice Address - Fax:518-785-1787
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307757363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04474599Medicaid
NYJ400333636Medicare PIN