Provider Demographics
NPI:1841854866
Name:FITZPATRICK, NICOLE (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:VORMITTAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:8 GREENHILL DR APT 38C
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-3717
Mailing Address - Country:US
Mailing Address - Phone:845-558-6782
Mailing Address - Fax:
Practice Address - Street 1:144 TODD HILL RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5916
Practice Address - Country:US
Practice Address - Phone:845-486-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist