Basic Information
Provider Information
NPI: 1760492631
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FITZ
FirstName: ERIC
MiddleName: W.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 S BEDFORD RD
Address2: CAREMOUNT MEDICAL, PC
City: MOUNT KISCO
State: NY
PostalCode: 105493446
CountryCode: US
TelephoneNumber: 9142411050
FaxNumber: 9146663893
Practice Location
Address1: 101 S BEDFORD RD STE 404
Address2: CAREMOUNT MEDICAL PC
City: MOUNT KISCO
State: NY
PostalCode: 105493455
CountryCode: US
TelephoneNumber: 9142411050
FaxNumber: 9146663893
Other Information
ProviderEnumerationDate: 08/09/2006
LastUpdateDate: 11/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X236241NYY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


Home