MEDICARE: CRISTINA SPATARO

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	101YM0800X	Mental Health Counselor	003397	NY

General Provider Information

NPI Number	:	1689080145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA SPATARO

Provider Business Mailing Address
First Line	:	1375 BROADWAY
Second Line	:	3RD FLOOR MICRO OFFICE #120
City	:	NEW YORK
State	:	NY
Zip	:	10018-7001
Country	:	US
Telephone Number	:	347-927-8792
Fax Number	:

Provider Business Practice Location Address
First Line	:	1375 BROADWAY
Second Line	:	3RD FLOOR MICRO OFFICE
City	:	NEW YORK
State	:	NY
Zip	:	10018-7001
Country	:	US
Telephone Number	:	347-927-8792
Fax Number	:

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

Provider Enumeration Date	:	07/05/2014
Last Update Date	:	07/05/2014

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Directions to “ CRISTINA SPATARO ” Practice Location

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