Provider Demographics
NPI:1699192278
Name:FITZPATRICK, JULIE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LORRI LN
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1707
Mailing Address - Country:US
Mailing Address - Phone:914-589-9955
Mailing Address - Fax:
Practice Address - Street 1:999 PELHAM PKWY N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4905
Practice Address - Country:US
Practice Address - Phone:718-519-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist