Provider Demographics
NPI:1669048765
Name:FITZPATRICK, ELIZABETH KEARNS (CCC-SLP, MSED)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KEARNS
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:CCC-SLP, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3954
Mailing Address - Country:US
Mailing Address - Phone:516-477-2424
Mailing Address - Fax:
Practice Address - Street 1:445 E MEADOW AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3954
Practice Address - Country:US
Practice Address - Phone:516-477-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030708235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist