Michael T Fitzgerald

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

01140001 Issued in NY

Practice address

3375 Park Ave
4000
Wantagh, NY 11793-3733

Phone

(516) 221-8838

Fax

(516) 221-4709

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699877803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "address_2": "4000",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-221-8838",
            "fax_number": "516-221-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "address_2": "4000",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-221-8838",
            "fax_number": "516-221-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "01140001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter P Figueroa, MSPT
• Maureen Casey Finley, LCSW - R
• Neil Finn, DDS
• First Aid Research Corp
• Charles Fiscella, D.C.
• Susan M Flaherty, LCSW
• Jason Todd Flicker, M.D.
• Rosemary Flynn, RD, CDN
• Caitlyn Foglietta
• Amanda Elhilow Forman, RDN

• Clinical Child & Adolescent Psychologist in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.