Provider Demographics
NPI:1316346208
Name:FITZPATRICK, GEORGANNE (MS, OTR)
Entity type:Individual
Prefix:
First Name:GEORGANNE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 SOUTH AVE. W
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090
Mailing Address - Country:US
Mailing Address - Phone:201-650-0903
Mailing Address - Fax:908-233-2267
Practice Address - Street 1:922 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1415
Practice Address - Country:US
Practice Address - Phone:201-650-0903
Practice Address - Fax:908-233-2267
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00427400225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics