Active NPI
Stacy Lynn Fitzgerald
- Pharmacist
- Cambridge, MA
National Provider Identifier
1043652605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH234714
- Practice address
- 625 Massachusetts Avenue
Cambridge, MA 02139 - Phone
- (617) 491-8157
- NPI assigned
- Jul 24, 2013
- Last updated
- Jul 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH234714 | MA | Primary |
Addresses
Primary practice location
625 Massachusetts Avenue
Cambridge, MA 02139
Mailing address
46 Gilbert St
Watertown, MA 02472
Phone (617) 393-0041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH234714 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1043652605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 GILBERT ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "02472",
"telephone_number": "617-393-0041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 MASSACHUSETTS AVENUE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02139",
"telephone_number": "617-491-8157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "STACY",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH234714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.