Provider Demographics
NPI:1356595755
Name:FITZER, JEROME (RPH)
Entity type:Individual
Prefix:MR
First Name:JEROME
Middle Name:
Last Name:FITZER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 INDUSTRIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3610
Mailing Address - Country:US
Mailing Address - Phone:781-729-8329
Mailing Address - Fax:
Practice Address - Street 1:10 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3610
Practice Address - Country:US
Practice Address - Phone:781-729-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist