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NPI Code Detail

MEDICARE: ROBERT P SPRAFKIN PHD

MEDICARE: ROBERT P SPRAFKIN PHD
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
1103T00000XPsychologist004308NY

General Provider Information

NPI Number : 1336149541
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT P SPRAFKIN PHD
Provider Business Mailing Address
First Line : 23 SUNSET TER.
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-1111
Country : US
Telephone Number : 315-625-8321
Fax Number : 315-472-2513
Provider Business Practice Location Address
First Line : 600 SOUTH WILBUR AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13204-2730
Country : US
Telephone Number : 315-476-7441
Fax Number : 315-476-1582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 12/02/2008

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