Provider Demographics
NPI:1871099200
Name:FITZGERALD, ELIZABETH MEADOWS (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MEADOWS
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:GARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1120
Mailing Address - Country:US
Mailing Address - Phone:610-299-0578
Mailing Address - Fax:
Practice Address - Street 1:3998 RED LION RD STE 106
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1439
Practice Address - Country:US
Practice Address - Phone:215-612-4143
Practice Address - Fax:215-612-4909
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD478086207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program