Provider Demographics
NPI:1174589253
Name:FITZGERALD, PATRICK ALFRED (ATC)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:ALFRED
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-1631
Mailing Address - Country:US
Mailing Address - Phone:650-368-8654
Mailing Address - Fax:650-368-0903
Practice Address - Street 1:1700 W HILLSDALE BLVD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3757
Practice Address - Country:US
Practice Address - Phone:650-574-6451
Practice Address - Fax:650-574-6518
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist