Provider Demographics
NPI:1386615987
Name:FITZGERALD, JAMES B (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3040 AMSDELL RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5835
Mailing Address - Country:US
Mailing Address - Phone:716-649-9000
Mailing Address - Fax:716-649-9005
Practice Address - Street 1:565 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2039
Practice Address - Country:US
Practice Address - Phone:716-826-7000
Practice Address - Fax:716-649-9005
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2013-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1707602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1609206OtherINDEPENDENT HEALTH
NY000528594005OtherBCBS
NY00026373106OtherUNIVERA HEALTHCARE
NY300080526OtherRR MEDICARE
NY040426000214OtherFIDELIS CARE OF NEW YORK
NY146163FFOtherPREFERRED CARE
NY01280102Medicaid
NYRA1911Medicare PIN
NY300080526OtherRR MEDICARE
NY00026373106OtherUNIVERA HEALTHCARE