MEDICARE: DR. SHARON DURITZO-SPOCINSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	32460	NY

General Provider Information

NPI Number	:	1164746863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON DURITZO-SPOCINSKI

Provider Business Mailing Address
First Line	:	3451 COLONY DRIVE
Second Line	:
City	:	BALDWIN HARBOR
State	:	NY
Zip	:	11510-5117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3451 COLONY DR.
Second Line	:
City	:	BALDWIN HARBOR
State	:	NY
Zip	:	11510-1151
Country	:	US
Telephone Number	:	516-868-6564
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2010
Last Update Date	:	03/24/2010

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