Provider Demographics
NPI:1063924942
Name:FITZPATRICK, CASEY L (PT)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:L
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:L
Other - Last Name:SCHWEINSBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:501 NORTON LN
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2359
Mailing Address - Country:US
Mailing Address - Phone:443-883-0748
Mailing Address - Fax:
Practice Address - Street 1:1400 NALLEY TER
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4434
Practice Address - Country:US
Practice Address - Phone:443-764-7535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD275632251P0200X
NY043454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1063924942Medicaid
MD158198800Medicaid