Provider Demographics
NPI:1003795535
Name:FITZGERALD, COURTNEY (DACM, MSTOM)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:DACM, MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2210
Mailing Address - Country:US
Mailing Address - Phone:860-338-4043
Mailing Address - Fax:
Practice Address - Street 1:515 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2210
Practice Address - Country:US
Practice Address - Phone:860-338-4043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2090-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist