MEDICARE: BARBARA SPENCER NP

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	363L00000X	Nurse Practitioner	330469	NY

General Provider Information

NPI Number	:	1578592382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA SPENCER NP

Provider Business Mailing Address
First Line	:	123 W 124TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4920
Country	:	US
Telephone Number	:	212-531-1300
Fax Number	:	212-531-0141

Provider Business Practice Location Address
First Line	:	123 W 124TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4920
Country	:	US
Telephone Number	:	212-531-1300
Fax Number	:	212-531-0141

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/08/2007

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