Provider Demographics
NPI:1871755611
Name:FITZGERALD, WENDY SUE (PT)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SUE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:SUE
Other - Last Name:FUCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8 W ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-1700
Mailing Address - Country:US
Mailing Address - Phone:203-356-9984
Mailing Address - Fax:
Practice Address - Street 1:345 BELDEN HILL RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3800
Practice Address - Country:US
Practice Address - Phone:203-762-3318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist