Doctor Name: | DAVID SPERA |
NPI Number: | 1245636638 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | F338863-1 |
Business Practice Address: | 6 Messina Ave Center Moriches, NY - 119341314 |
Business Phone Number: | 6319091682 |
Business Fax Number: | |
Mailing Address: | 6 Messina Ave, CENTER MORICHES |
State: | NY |
Postal Code: | 119341314 |
Phone Number: | 6319091682 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2014 |
NPI Last Update Date: | 11/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F338863-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |