Healthcare Provider Details

I. General information

NPI: 1518861061
Provider Name (Legal Business Name): MICHELLE SPIRA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 DINSMORE AVE
FAR ROCKAWAY NY
11691-4718
US

IV. Provider business mailing address

1321 DINSMORE AVE
FAR ROCKAWAY NY
11691-4718
US

V. Phone/Fax

Practice location:
  • Phone: 917-930-1436
  • Fax:
Mailing address:
  • Phone: 917-930-1436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number908629
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: