Provider Demographics
NPI:1053773275
Name:FITZGERALD, JOHN FRANK (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANK
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 W 8TH ST # L18
Mailing Address - Street 2:506 6TH ST, BROOKLYN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11215
Mailing Address - Country:US
Mailing Address - Phone:718-789-3000
Mailing Address - Fax:
Practice Address - Street 1:653 W 8TH ST # L18
Practice Address - Street 2:506 6TH ST, BROOKLYN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-789-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-26
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18440332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology