Carol Ann Fitzsimmons, RN

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Setauket, NY

NPI 1487810552 · NPPES record last updated Sep 17, 2009

Key facts

NPI
1487810552
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
48 Julia Circle
Setauket, NY 11733
Phone
(631) 832-9202
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

48 Julia Circle
Setauket, NY 11733

Mailing address

48 Julia Circle
Setauket, NY 11733
Phone (631) 832-9202

Other identifiers

IdentifierTypeStateIssuer
02631827MedicaidNY

Other providers in Setauket, NY

All providers in Setauket, NY · Student in an Organized Health Care Education/Training Program in New York

Sources for this page

Verify at the official NPI Registry.