Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | F34746001 | NY |
NPI | 1861143232 |
---|---|
Provider Name | Neethu Fitzsimmons |
First Address | Danbury, CT 06810-1518 |
Second Address | Carmel, NY 10512-1921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2022 |
Last Update Date | 17/01/2022 |