Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 14868 | NH |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 14868 | NH |
NPI | 1801917216 |
---|---|
Provider Name | Patrick Fitzpatrick |
First Address | Littleton, NH 03561 |
Second Address | Littleton, NH 03561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 19/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30228266 | (05) | NH |