Healthcare Provider Details

I. General information

NPI: 1346599172
Provider Name (Legal Business Name): NEDA SPASEVSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 E WASHINGTON ST
SYRACUSE NY
13210-1173
US

IV. Provider business mailing address

4317 CARRIGAN CIR
SYRACUSE NY
13215-1333
US

V. Phone/Fax

Practice location:
  • Phone: 315-426-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number561895
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: